Allogeneic Hematopoietic Stem Cell Transplantation for Treatment of Philadephia Chromosome Negative Acute Lymphoblastic Leukemia.

To explore the optimum donor selection of allogeneic hematopoietic stem cell transplantation (allo-HSCT) applied in patients with Philadephia chromosome-negative acute lymphoblastic leukemia(Ph^- ALL) and investigate its relevant prognostic factors.

A total of 48 adult patients with Ph^- ALL who had admitted to our hospital and been treated by allo-HSCT from February 2002 to May 2008 were followed up until July 2008. They were divided into match related donor(MRD -HSCT) group, match unrelated donor(MUD-HSCT) and Haploidentical (Haplo-HSCT) group. Clinical characteristics of these groups were retrospectively analyzed. Survival data were analyzed by the Kaplan-Meier method and the prognostic factors were analyzed with the COX regression model.

Of all the 48 cases, 5-year overall survival(OS) was 45.4±8.1%, disease free survival(DFS) was 40.7±7.9%.The 5-year OS and DFS of MRD –HSCT subgroup, MUD-HSCT subgroup and Haplo-HSCT subgroup were 50%±14.4%,53.2%±13.2%, 31.3%±13.6%(p=0.048) and 44.7%±13.3%,41.4%±13.6%,32.1±14.2%(p=0.167), respectively. Haplo-HSCT subgroup 5-year OS lower than other two subgroups, which showed statistical significance. GradeIIto‡W acute graft versus host disease(aGVHD) [p=0.001,RR=6.980] and white blood cell at diagnosis higher than 30×10⁹ /L[p=0.028, RR=2.679]were the risk factor of OS in multiple covariate analysis model. The HSCT type was not independent risk factor of OS.

MUD-HSCT and MRD-HSCT have similar efficacy in adult Ph^- ALL. Haplo-HSCT can be a distinct option in High-risk adult Ph^- ALL patients without a MRD and MUD.

No relevant conflicts of interest to declare.