title: [Salvaged allogeneic hematopoietic stem cell transplantation for refractory/recurrent acute myeloid leukemia].
abstract: OBJECTIVE
  To evaluate the efficacy of salvaged allogeneic hematopoietic stem cell transplantation (allo-HSCT) for refractory/recurrent acute myeloid leukemia (AML).
  
  
  METHODS
  A total of 45 patients with refractory/recurrent AML were enrolled from September 2006 to April 2010. The median blasts in bone marrow (BM) were 36% (20% to 92%) before conditioning. The donors were identical siblings (6) or unrelated ones (9) or haploidentical family members (30). Conditioning regiments were individualized according to patients' status, the regimen with high-dose cytarabine plus BuCy/CY was mostly used (20). The patients with impaired organ function received above regimen except using fludarabine instead of cyclophosphamide (16). FLAG followed by reduced-intensified BuCy was employed for the recipients with more than 40% blasts in BM (6) to reduce leukemia burden. TBI/CY or TBI/Fludarabine was used for the recipients with extramedullary infiltration of leukemia or multidrug resistant leukemia. G-CSF, MTX, NVT, Vm26, Acla or Thaltipa was added into conditioning regiments according to leukemia character.
  
  
  RESULTS
  All but 2 patients attained durable engraftment. The incidence of grade II to IV aGVHD and cGVHD were 34%, 59.1%, respectively. With median follow-up 30 (0.5 - 57) months, the relapse rate was 29.2%. Twenty-nine of 45 (60.2%) patients remained in complete remission since salvaged HSCT. Three-years disease-free survival and overall survival were 60.2% and 62.6%, respectively.
  
  
  CONCLUSIONS
  Our results indicated that the combination of salvaged HSCT with prophylactic immunotherapy might be a promising modality for treatment of refractory/recurrent AML, even with high leukemia burden.
authors.affiliation: Beijing Dao-pei Hospital, Beijing 100049, China.
authors.forename: Jing-bo
authors.initials: JB
authors.lastname: Wang
authors.forename: Tong
authors.initials: T
authors.lastname: Wu
authors.forename: Wan-ming
authors.initials: WM
authors.lastname: DA
authors.forename: Chun-rong
authors.initials: CR
authors.lastname: Tong
authors.forename: Yuan
authors.initials: Y
authors.lastname: Sun
authors.forename: Yan-li
authors.initials: YL
authors.lastname: Zhao
authors.forename: Yu-ming
authors.initials: YM
authors.lastname: Yin
authors.forename: Xing-yu
authors.initials: XY
authors.lastname: Cao
authors.forename: Yue
authors.initials: Y
authors.lastname: Lu
authors.forename: Yan-qun
authors.initials: YQ
authors.lastname: Gao
authors.forename: Jia-rui
authors.initials: JR
authors.lastname: Zhou
authors.forename: Jian-ping
authors.initials: JP
authors.lastname: Zhang
authors.forename: Rong-mu
authors.initials: RM
authors.lastname: Luo
authors.forename: Wei
authors.initials: W
authors.lastname: Zou
authors.forename: Dao-pei
authors.initials: DP
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D012008:Recurrence; D015996:Survival Rate; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult