title: Haploidentical stem cell transplantation for acute leukemia patients who experienced early relapse within one year after the first transplantation.
abstract: To assess the safety and efficacy of allogeneic stem cell transplantation from haploidentical related donors (haplo-SCT) as 2nd transplantation for patients with early relapsed disease, we retrospectively evaluated 7 consecutive patients (median age, 42 years; range, 29-63 years) who experienced relapse within 1 year of the 1st transplantation and received haplo-SCT as a 2nd transplantation. Among the 7 patients who received haplo-SCT, 2 who were in morphologically complete remission (CR) at transplantation were conditioned with a reduced-intensity regimen, and the 5 non-CR patients were conditioned with a myeloablative regimen. Both conditioning regimens included antithymocyte globulin. Graft-versus-host disease (GVHD) prophylaxis consisted of tacrolimus and methylprednisolone. Sustained neutrophil engraftment was achieved in all 7 patients. One patient developed severe acute GVHD. Notably, only 1 patient experienced relapse, and each patient achieved longer CR duration than after the 1st transplantation. Three of the 7 patients died from treatment-related causes: acute GVHD, post-transplantation lymphoproliferative disorder, and bacterial pneumonia. At the time of analysis, the 2-year overall survival rate of these 7 patients was 42.9%. This suggests that use of haploidentical related donors is a viable alternative for 2nd transplantation and should be confirmed in larger cohorts.
authors.affiliation: Department of Medicine and Clinical Science, Gunma University, Gunma, Japan; Leukemia Research Center, Saiseikai Maebashi Hospital, Gunma, Japan. Electronic address: hiroakis@ked.biglobe.ne.jp.
authors.forename: H
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: Leukemia Research Center, Saiseikai Maebashi Hospital, Gunma, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Hatsumi
authors.affiliation: Leukemia Research Center, Saiseikai Maebashi Hospital, Gunma, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takada
authors.affiliation: Leukemia Research Center, Saiseikai Maebashi Hospital, Gunma, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Sakura
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007938:Leukemia / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous