Clinical efficacy of double autologous hematopoietic stem cell transplantation in the treatment of adult acute lymphoblastic leukemia]

To evaluate the clinical efficacy of double autologous hematopoietic stem cell transplantation (DAHSCT) in adult acute lymphoblastic leukemia and analyse the affecting factors.Thirteen adult acute lymphoblastic leukemia (ALL) patients received the first AHSCT in 12 months after complete remission (CR). The first conditioning regimen was Vp16,600-1000 mg or Ara-C 2-4 g/m2, CTX 120 mg/kg, total body irradiation(TBI) 7.5-9.0 Gy and in 6 patients BCNU 125 mg was added. All the patients received the second AHSCT in 4 to 10 months after the first AHSCT. The second conditioning regimen was Vp16,600-1000 mg or Ara-C 2-4 g/m2, Mel 140 mg/m2, CTX 120 mg/kg.All engrafted patients had rapid hematopoietic reconstitution. There was no AHSCT related death. The median follow-up duration was 837 days. Seven of the 13 DAHSCT patients were alive. The 3 year disease-free survival (DFS) was (53.8 +/- 7.7)%. Those who had more lymphoblasts in bone marrow at the second AHSCT than that at the first AHSCT had greater probability of relapse.It suggested that DAHSCT could be used as an important treatment owing to its low AHSCT related death and relatively long DFS.