Volume 9 Issue 6
Nov.  2018
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Zhang Jingwen, Sun Yanling, Li Xudong. Secondary transplantation strategy for graft failure of haploidentical hematopoietic stem cell transplantation for acute lymphocytic leukemia[J]. ORGAN TRANSPLANTATION, 2018, 9(6): 441-444. doi: 10.3969/j.issn.1674-7445.2018.06.008
Citation: Zhang Jingwen, Sun Yanling, Li Xudong. Secondary transplantation strategy for graft failure of haploidentical hematopoietic stem cell transplantation for acute lymphocytic leukemia[J]. ORGAN TRANSPLANTATION, 2018, 9(6): 441-444. doi: 10.3969/j.issn.1674-7445.2018.06.008
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Secondary transplantation strategy for graft failure of haploidentical hematopoietic stem cell transplantation for acute lymphocytic leukemia

doi: 10.3969/j.issn.1674-7445.2018.06.008

  • Department of Hematology, the Third Affiliated Hospital of Sun Yat-sen University, Institute of Hemopathy of Sun Yat-sen University, Guangzhou 510630, China

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  • Corresponding author: Li Xudong, Email:13631359815@139.com
  • Received Date: 2018-08-23
    Available Online: 2021-01-19
  • Publish Date: 2018-11-15
    Abstract
  •   Objective  To explore the secondary transplantation strategy for graft failure of the primary haploidentical hematopoietic stem cell transplantation (haplo-SCT) associated with fatal complications in a patient with acute T-cell lymphocytic leukemia.  Methods  One male patient was diagnosed with acute T-cell lymphocytic leukemia. In November 2015, he received haplo-SCT from his sister as the donor. But graft failure was developed and complicated by Escherichia coli sepsis, serum disease, hepatic venous occlusion and multiple organ failure. At 32nd d after the first transplantation, secondary haplo-SCT from his father as the donor was performed. Prior to secondary transplantation, chemotherapy pretreatment was not conducted. Post-transplantation cyclophosphamide (PTCy)-based prevention measure against the graft-versus-host disease (GVHD) was adopted after transplantation.  Results  White blood cells were implanted on the 12nd d and platelet implantation was performed on the 67th d after haplo-SCT. Serum disease, septicemia and hepatic venous occlusion were cured and organ function was improved. However, the patient died from the recurrence of leukemia at 18th months after transplantation (June 2017).  Conclusions  Prior to secondary haplo-SCT, PTCy prevention measures against the GVHD rather than pretreated chemotherapy probably contributes to the success of transplantation.

     

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