title: [Allogeneic hematopoietic stem cell transplantation for acute leukemias of ambiguous lineage in adults: a comparison between the conditioning of different intensities].
abstract: OBJECTIVE
  To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the conditioning of different intensities for acute leukemias of ambiguous lineage (ALAL).
  
  
  METHODS
  A total of 38 ALAL patients were treated with two conditioning of different intensities in our hospital from March 2002 to August 2010. The standard conditioning included TBI + Cy or Bu + Cy, intensified conditioning included Fludarabine + Ara-C + TBI + Cy. Cyclosporine A (CsA) and methotrexate (MTX) were administered in patients with human leukocyte antigen-matched sibling donor. And CsA, MTX plus antihuman thymocyte globulin and/or mycophenolate were used in all patients with HLA-mismatched related donor and unrelated donors transplants for graft-versus-host disease (GVHD) prophylaxis. COX regression was used to evaluate the prognostic factors of ALAL.
  
  
  RESULTS
  Among 38 ALAL patients, 19 received the standard conditioning while another 19 the intensified conditioning. All patients achieved hematopoietic reconstitution. The 5-year overall survival (OS) and the disease-free survival (DFS) were 35.5% and 25.7% respectively. The 5-year OS rates were 20.2% and 48.1% (P = 0.233) and DFS 6.5% and 43.1% (P = 0.031) in the standard and intensified conditioning groups respectively. The 5-year cumulative relapsing incidence was 58.9% in all patients and 87.6% vs 30.4% in the standard and intensified conditioning groups respectively (P = 0.003). Through a COX regression model for univariate analysis, the intensified conditioning and chronic GVHD were protective factors for DFS (P = 0.001, 0.031).
  
  
  CONCLUSIONS
  The intensified conditioning in ALAL patients undergoing allo-HSCT may improve the long-term patient survival and decrease the relapse of leukemia. The graft versus leukemic effect has some efficacy in ALAL patients undergoing allo-HSCT.
authors.affiliation: Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yin-kui
authors.initials: YK
authors.lastname: Chen
authors.forename: Qi-fa
authors.initials: QF
authors.lastname: Liu
authors.forename: Zhi-ping
authors.initials: ZP
authors.lastname: Fan
authors.forename: Qian-li
authors.initials: QL
authors.lastname: Jiang
authors.forename: Jie
authors.initials: J
authors.lastname: Zhao
authors.forename: Qi
authors.initials: Q
authors.lastname: Wei
authors.forename: Xiao-fang
authors.initials: XF
authors.lastname: Li
authors.forename: Guo-pan
authors.initials: GP
authors.lastname: Yu
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
authors.forename: Yan-yan
authors.initials: YY
authors.lastname: Chai
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007938:Leukemia / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult