title: Comparative study of the efficacy of allogeneic hematopoietic stem cell transplantation from human leukocyte antigen-haploidentical related and unrelated donors in the treatment of leukemia.
abstract: OBJECTIVE
  To compare the efficacy of hematopoietic stem cell transplantation (HSCT) from human leukocyte antigen (HLA)-haploidentical related donors (RD) and unrelated donors (URD) in the treatment of leukemia.
  
  
  METHODS
  Ninety-three leukemia patients underwent allogeneic HSCT were divided into two groups: 51 cases of RD-HSCT and 42 cases of URD-HSCT. In the RD-HSCT group, a preconditioning regimen with fludarabine (Flu) + busulfan (Bu) + cytosine arabinoside (Ara-C) was used in 42 patients and total body irradiation (TBI) + Flu + Ara-C was used in the remaining 9.
  
  
  RESULTS
  In the URD-HSCT group, a modified preconditioning regimen with Bu + cyclophosphamide was used in 35 patients, while the other 7 patients underwent treatment with TBI + Flu. After transplantation, the occurrence rate of grade II-IV acute graft-versus-host disease (GVHD) was 46.0 and 51.2% in the two groups. Likewise, the rate of chronic GVHD was 46.0 and 63.4%, respectively. No significant differences in the occurrence of acute and chronic GVHD were detected between the two groups. The differences in early-stage infection rate after transplantation, recurrence rate, 3-year survival rate, and disease-free survival rate between the two groups were not significant.
  
  
  CONCLUSIONS
  HLA-haploidentical RD-HSCT with enhanced preconditioning and administration of immunosuppressants showed a clinical efficacy similar to that of URD-HSCT against leukemia, without the risk of increased infection and GVHD.
authors.affiliation: Department of Hematology, Beijing Military General Hospital, Beijing, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Yang
authors.forename: Yingjian
authors.initials: Y
authors.lastname: Si
authors.forename: Huiren
authors.initials: H
authors.lastname: Chen
authors.forename: Xuepeng
authors.initials: X
authors.lastname: He
authors.forename: Jinxing
authors.initials: J
authors.lastname: Lou
authors.forename: Xue
authors.initials: X
authors.lastname: Bai
authors.forename: Junfeng
authors.initials: J
authors.lastname: Du
authors.forename: Zhi
authors.initials: Z
authors.lastname: Guo
authors.forename: Peng
authors.initials: P
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000401:mortality; D006680:HLA Antigens / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D007938:Leukemia / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019172:Transplantation Conditioning; D061349:Unrelated Donors
chemical_list: D006680:HLA Antigens