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ctt-journal > Pshonkin 1 et al. (Abstract)

Pshonkin 1 et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract55
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation", Saint Petersburg, Russia, September 18–20, 2010

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Hematopoietic stem cell transplantation (HSCT) in acute leukemia: pre- and post-transplant periods at the hematology department of a city clinical hospital

Aleksey V. Pshonkin, Edvard R. Biyachuev, Svetlana V. Minenko, Vadim V. Ptushkin

Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia

Correspondence: Aleksey V. Pshonkin, Federal Scientific Clinical Center of Pediatric Hematology, Oncology and Immunology, 117/2, Leninsky pr., 117997, Moscow, Russia, E-mail: pshoni@spam is badrambler.ru

Abstract

HSCT is now the only effective method for treatment of patients with prognostically unfavorable subtypes of acute leukemia and in relapse. At the same time, a restricted number of beds in transplantation settings do not allow successful treatment of any patient under optimal conditions. Clinical approaches must aim for the most rational arrangement of transplantation-associated treatment of the patient; in other words, to minimize the patient hospitalization time period at the transplantation center.

Objectives of the study: Arranging the interactions between the hematology department of a city clinical hospital and a transplantation center when treating unfavorable clinical forms of acute leukemia and/or relapses of acute leukemia at all steps: including high-resolution HLA typing, preliminary selection of related or unrelated donors, performing inductive therapies according to appropriate protocols, post-transplant period with detection of chimerism, monitoring of immunosuppression and control of infectious complications. We observed eleven patients since the onset of their acute leukemia, who were referenced as a high-risk group, and twelve patients with relapsing acute leukemia. Their clinical characteristics and number of transplants are presented in the table.

Acute leukemia, primary

Allo-HSCT

Relapses of acute leukemia

Allo-HSCT

Number of patients

11

3

12

7

Pro-B ALL

1 with t(4;11)

-

-

-

Common ALL

4 (2 with t(9:22) and 2 with hyperleucocytosis)

2 with t(9:22)

5

2

T-ALL

1

-

2

2

ANLL М0 FAB

1

-

1

1

ANLL М2 FAB

1

-

1

1

ANLL М4 FAB

3

1

2

1

Biphenotypic leukemia

-

-

1

-


Results: Over 3 years we have carried out high-resolution HLA typing for twenty-three patients with high-risk acute leukemia or relapses of acute leukemia, for three patients compatible related donors have been found, of them, two patients have been transplanted, and one has died due to progression of the disease. In nine cases, allogeneic unrelated transplantation has been performed. A search for unrelated donors was carried out for 3 patients. During the post-transplant period, we performed follow-up on eight patients: three patients have died at different terms after transplantation, and five patients underwent subsequent observation (immunosuppression monitoring, control of infectious complications). Hence, an algorithm has been developed for handling pre- and post-transplant patients using this experience.

Keywords: acute leukemia, hematopoietic stem cell transplantation, pre- and post-transplant periods, city clinical hospital

 

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