ISSN 1866-8836
Клеточная терапия и трансплантация

AL-05. Haploidentical hematopoietic stem cell transplantation for chemoresistant relapses of acute leukemia in children

Dair Nurgaliev, Balzhan Umirbekova, Gulshat Kusherova                                                

UMC Corporative Foundation, Nur-Sultan, Kazakhstan

Dr. Dair Nurgaliev, phone: +7 172 702 070

doi 10.18620/ctt-1866-8836-2021-10-3-1-148


In the clinic of the NSCMC CF UMC, since 2016, haplo-HSCT has been started in children with relapses of acute leukemia who did not rearch remission. This option was offered to non-responders after two blocks of anti-relapse therapy and two blocks of FLAG-IDA. There was also no time to searching a histocompatible donor. Therefore, this was regarded as “salvage therapy”. A total of 8 haplo-HSCT were performed in children with chemically resistant relapses of ALL and AML. Conditioning began 7-10 days after the end of the second FLAG-IDA, with a WBC count of 0.1-1.0. None of the patients achieved hematological response (assessed by bome marrow smear) prior to HSCT. Conditioning regimen included treosulfan, fluorabin, thiotepa for ALL, and melphalan for AML. GVHD prophylaxis consisted of cyclophosphamide 50 mg/kg on D+3 and D+4. In most patients conditioning regimen was accompanied by infectious or non-infectious complications. With the development of acute renal failure, hemodialysis sessions, antibiotic therapy, antifungal and antiviral therapy were carried out. Correction of electrolyte and metabolic disorders was performed. Graft engraftment was observed in 5 patients. Three patients died due to infectious complications. One patient died due to disease progression. In total, four patients went into complete remission with 90% or more donor chimerism. The maximum observation period after haplo-HSCT is 5 years.


Thus, we have seen about 50% survival rate of patients with chemoresistant recurrence of acute leukemia in pediatric haplo-HSCT recipients. Survival largely depends on underlying disease and presence of infectious complications.


Hematopoietic stem cell transplantation, haploidentical, leukemia, children.

Volume 10, Number 3

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doi 10.18620/ctt-1866-8836-2021-10-3-1-148

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