title: [Two Kinds of HLA-mismatched Allogeneic Hematopoictic Stem Cell Transplantation for Treatment of Hematologic Malignancies].
abstract: OBJECTIVE
  To investigate the safety and effectiveness of HLA-mismatched allogeneic hematopoietic stem cell transplantation (allo-HSCT) combined with related haploidentical bone marrow infusion for treatment of hematologic malignancies and to explore the mathod for reduction of aGVHD incidence and clinical significance.
  
  
  METHODS
  A total of 30 patients with hematologic malignancies (8 cases of AML, 17 AML, 2 MDS and 3 Mix-AL) received related haploidentical and unrelated HLA-mismatched allo-HSCT combined with related haploidentical bone marrow infusion. Among them 20 cases received related haploidentical transplantation of the first donor, 10 cases received unrelated HLA-mismatched treaplantation. The new conditioning regimen for the patients underwent allo-HSCT consisted of fludarabine, busulfan, Me-CCNU and cyclophosphamide. The drugs for GVHD prophylaxis included cyclosporine A and methotrexate, while mycophenolate mofetil and rabbit anti-T-lymphocyte globulin (ATG) were used.
  
  
  RESULTS
  All the patients achieved full engraftment. The median time for neutrophils to reach over 0.5 × 10(9)/L was 14 days (8-26 days), while the median time for platelets to reach over 20 × 10(9)/L was 11.5days (10-24 days). The incidence of I-II grade of aGVHD at 100 d was 22.28% (95% CI 9.9%-34.7%), the incidences of II-IV and III-IV grade of aGVHD were 22.7% (95% CI, 10%-35.4%) and 12.7% (95% CI 6.9%-15.5%) respectively. The incidences of I-II and III-IV cGVHD were 13.3% (95% CI, 1.4%- 26.8%) and 3.3 % (95% CI, 0%-12.2%), one case (3.3%) was in extensive cGVHD. DFS and OS of 2 years were 81.1% (95% CI, 66.0%-96.2%) and 68.2% (95% CI 51.0%-85.4%).
  
  
  CONCLUSIONS
  These data suggest that the incidence of grade II-IV grade of aGVHD in recipients of 2 partially HLA-matched units was lower, co-infusion of haplo-BM and partially matched units in allogeneic transplantation is safe and effective for reducing the incidence of aGVHD and improving the survival in DFS.
authors.affiliation: Center of Hematopoietic Cell Transplantation, Shanghai Dao-Pei Hospital, Fudan University; The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China.
authors.forename: Wei-Da
authors.initials: WD
authors.lastname: Li
authors.affiliation: Center of Hematopoietic Cell Transplantation, Shanghai Dao-Pei Hospital, Fudan University; The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China.
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Gao
authors.affiliation: Center of Hematopoietic Cell Transplantation, Shanghai Dao-Pei Hospital, Fudan University; The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China.
authors.forename: Xin-Jian
authors.initials: XJ
authors.lastname: Yu
authors.affiliation: Center of Hematopoietic Cell Transplantation, Shanghai Dao-Pei Hospital, Fudan University; The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China.
authors.forename: Da-Yu
authors.initials: DY
authors.lastname: Lu
authors.affiliation: Center of Hematopoietic Cell Transplantation, Shanghai Dao-Pei Hospital, Fudan University; The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China. E-mail: weidali2004@163.com.
authors.forename: Dao-Pei
authors.initials: DP
authors.lastname: Lu
mesh_terms: D000961:Antilymphocyte Serum / Q000627:therapeutic use; D002066:Busulfan / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D006086:Graft vs Host Disease / Q000517:prevention & control*; D006680:HLA Antigens / Q000235:genetics; D019337:Hematologic Neoplasms / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015994:Incidence; D007938:Leukemia / Q000628:therapy*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D033581:Stem Cell Transplantation; D014019:Tissue Donors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000961:Antilymphocyte Serum; D006680:HLA Antigens; D016572:Cyclosporine; D014740:Vidarabine; D002066:Busulfan; D009173:Mycophenolic Acid; C024352:fludarabine