title: [Therapeutic efficacy of second allo-HSCT for aplastic anemia after failure of first allo-HSCT].
abstract: This study was purposed to evaluate the curative efficacy of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) after failure of the first allo-HSCT in aplastic anemia patients, the cause of implant failure after allo-HSCT and clinical data of 10 severe aplastic anemia (SAA) patients in the second allo-HSCT were retrospectively analyszed. The second HSCT conditioning programs include: cyclophosphamide (CTX) + fludarabine (FLU)+ anti-thymocyte globulin (ATG) combination chemotherapy for 3 cases; CTX + FLU + white busulfan (Bu) + ATG combination chemotherapy for 7 cases. The prevention regimen of graft-versus-host disease (GVHD) include cyclosporine (CsA), mycophenolate mofetil (MMF) and methotrexate (MTX). The median count of mononuclear cell infusion was 12.17 (5.99-18.12)×10(8)/kg. The CD34(+) cell count was 5.2 (3.8-10.9)×10(6)/kg. The results showed that 10 evaluable patients achieved hematopoietic reconstitution with absolute neutrophil >0.5×10(9)/L, platelets >20×10(9)/L at 15d (8-21d) and 17d (11-27d) after transplantation. The grade I aGVHD occurred in 2 case, grade II in 1 case, chronic GVHD in 3 cases. Transplant-related deaths occurred in 4 cases. The disease-free survival rate, transplant-related mortality, GVHD after transplantation were 60%, 40% and 50% respectively. It is concluded that the second allo-HSCT is an effective therapy for aplastic anemia after allo-HSCT implant failure.
authors.affiliation: Clinical Medical College of Anhui Medical University, General Hospital of Beijing Military Command, Beijing 100700, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Zhu
authors.affiliation: Clinical Medical College of Anhui Medical University, General Hospital of Beijing Military Command, Beijing 100700, China. E-mail: chenhui-ren@medmail.com.cn.
authors.forename: Hui-Ren
authors.initials: HR
authors.lastname: Chen
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Command, Beijing 100700, China.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Guo
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Command, Beijing 100700, China.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Liu
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Command, Beijing 100700, China.
authors.forename: Xue-Peng
authors.initials: XP
authors.lastname: He
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Command, Beijing 100700, China.
authors.forename: Jing-Xing
authors.initials: JX
authors.lastname: Lou
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Command, Beijing 100700, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Yang
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Command, Beijing 100700, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Hematology, General Hospital of Beijing Military Command, Beijing 100700, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Chen
mesh_terms: D064591:Allografts; D000741:Anemia, Aplastic / Q000628:therapy*; D000961:Antilymphocyte Serum; D016572:Cyclosporine; D018572:Disease-Free Survival; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008727:Methotrexate; D009173:Mycophenolic Acid / Q000031:analogs & derivatives; D012189:Retrospective Studies
chemical_list: D000961:Antilymphocyte Serum; D016572:Cyclosporine; D009173:Mycophenolic Acid; D008727:Methotrexate