Allogeneic hematopoietic stem cell transplantation for chronic myelomonocytic leukemia

Abstract

Objective To explore the therapeutic efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in chronic myelomonocytic leukemia (CMML) patients. Methods The clinical data were retrospectively analyzed for 19 CMML patients undergoing allo-HSCT. Engraftment, graft versus host disease (GVHD), infection, relapse, splenomegaly and survival were observed. And the clinical outcomes of allo-HSCT for CMML were analyzed. Results Hematopoiesis reconstitution was not attained in 2 recipients due to early death post-transplantation. Neutrophil engraftment was obtained in 17 recipients with a median time of 14(11-18) days. Neutrophil engraftment and platelet engraftment were achieved in 15 recipients with a median time of platelet engraftment at 15 (12~70) days. Seven patients developed acute GVHD (grade 1, n=5; grade 2~4, n=3) while another 8 patients had chronic GVHD (extensive, n=5). Ten patients (52.6 %)had palpable splenomegaly (SPM) before allo-HSCT, 8 patients were diagnosed ultrasonically after transplantation, all 4 patients without a significant reduction of spleen died while all 4 patients with a significant reduction of spleen survived. After a median follow-up period of 31 (6-68) months, 3-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR) and non-relapse mortality (NRM) were (58.2±12.5)%, (36.3±14)%, (39.9±19)% and (37±12.6)% respectively. Conclusions As an effective therapy for CMML, allo-HSCT may improve the survival of CMML patients. Palpable SPM pre-transplantation and no significant reduction post-transplantation are probably poor prognostic factor. Key words: Allogeneic hematopoietic stem cell transplantation; Leukemia; Splenomegaly