A single-center retrospective study of salvage allogeneic hematopoietic stem cell transplantation pretreated with MeCBA regimen for refractory/relapsed acute myeloid leukemia

TL;DR

This study examines the outcomes of a specific pre-transplant treatment for patients with relapsed or refractory acute myeloid leukemia.

Contribution

The study evaluates the MeCBA regimen as a novel pre-transplant treatment for R/R AML patients undergoing allogeneic stem cell transplantation.

Findings

The 3-year overall survival rate was 70.0% after the MeCBA regimen and transplantation.

The 3-year event-free survival rate was 65.3% with a low cumulative relapse rate of 21.2%.

Most patients experienced only mild gastrointestinal side effects, with no severe organ toxicity.

Abstract

2018年1月至2022年6月期间，30例难治/复发急性髓系白血病（R/R AML）患者在河南省肿瘤医院接受MeCBA方案（司莫司汀+克拉屈滨+白消安+阿糖胞苷）增强预处理挽救性异基因造血干细胞移植（allo-HSCT）。30例患者中男16例，女14例，中位年龄37（16～53）岁。同胞全相合供者移植3例，无关供者移植1例，单倍体移植26例。移植前中位化疗疗程数为4（3～22）个。移植后粒细胞、血小板植入中位时间分别为14（9～22）d、18（10～40）d，移植后30 d粒细胞累积植入率为100％，移植后100 d血小板累积植入率为96.7％（95％CI 85.4％～97.5％）。22例（73.3％）患者出现1～2级胃肠道不良反应，未出现3～4级脏器毒性。中位随访37.1个月，移植后3年总生存率为70.0％（95％CI 50.3％～83.1％），无事件生存率为65.3％（95％CI 44.8％～79.8％），累积复发率为21.2％（95％CI 9.2％～44.4％），非复发死亡率为16.7％（95％CI 7.3％～35.5％）。