title: Allogeneic hematopoietic stem cell transplantation for patients with acute leukemia.
abstract: OBJECTIVE
  The purposes of this study were to assess the efficacy of allogeneic hematopoietic stem cell transplantation (HSCT) for acute leukemia (AL) and analyze the factors affecting the prognosis of these patients.
  
  
  METHODS
  The clinical and follow-up data of 93 AL patients (median age, 30 years) undergoing allogeneic HSCT in Xiangya Hospital over the past 12 years were collected, and the potential factors affecting the efficacy and prognosis of allogeneic HSCT patients were determined.
  
  
  RESULTS
  Hematopoietic reconstitution was achieved in 90 patients. At the last follow-up, the incidences of severe acute graft versus host disease (aGvHD) and extensive chronic GvHD (cGvHD) were 14.0% and 20.0%, the 3-year cumulative incidence of transplantation related mortality (TRM) and relapse rate were 16.8%±6.1% and 21.3%±6.7%, and the estimated 3-year overall survival (OS) and disease-free survival (DFS) of the patients were 64.6%±5.4% and 56.5%±5.5%, respectively. Univariate analysis indicated that age older than 40 years, HLA mismatch, and severe lung infection within the first 100 days after transplantation were risk factors for severe aGvHD, age older than 40 years, HLA mismatch, severe lung infection within the first 100 days after transplantation, and severe aGvHD were risk factors for TRM, high-risk AL and lack of cGvHD were risk factors for relapse (all P<0.05). Survival estimation showed that HLA mismatch, severe lung infection occurring within the first 100 days post-transplantation, high-risk AL severe aGvHD and lack of cGvHD were risk factors associated with poor prognosis (all P<0.05). Further multivariate analyses revealed that severe lung infection within the first 100 days post-transplantation, severe aGvHD and lack of cGvHD were independent risk factors for unfavorable outcomes (all P<0.05).
  
  
  CONCLUSIONS
  Allogeneic HSCT can improve the DFS of AL patients, and severe lung infection within the first 100 days post-transplantation, severe aGvHD and lack of cGvHD are independent risk factors affecting the prognosis.
authors.affiliation: Department of Hematology, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Chen
authors.forename: Yajing
authors.initials: Y
authors.lastname: Xu
authors.forename: Gan
authors.initials: G
authors.lastname: Fu
authors.forename: Yi
authors.initials: Y
authors.lastname: Liu
authors.forename: Jie
authors.initials: J
authors.lastname: Peng
authors.forename: Bin
authors.initials: B
authors.lastname: Fu
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Yuan
authors.forename: Hongya
authors.initials: H
authors.lastname: Xin
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhu
authors.forename: Qun
authors.initials: Q
authors.lastname: He
authors.forename: Dengshu
authors.initials: D
authors.lastname: Wu
authors.forename: Yigang
authors.initials: Y
authors.lastname: Shu
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Li
authors.forename: Xielan
authors.initials: X
authors.lastname: Zhao
authors.forename: Fangping
authors.initials: F
authors.lastname: Chen
keywords: Leukemia; graft-versus-leukemia effect; hematopoietic stem cell transplantation (HSCT)