Objective: To evaluate the clinical outcome of autologous stem cell transplantation (ASCT) in acute lymphoblastic leukemia (ALL) and the affected factors.
Methods: Data of 30 ALL patients received ASCT in our hospital between July 1987 and December 1997 were retrospectively analyzed. Twenty-four of them were in the first complete remission (CR(1)) and six in the second complete remission (CR(2)) or early relapse (ER). Conditioning regimens were CTX 120 mg/kg + single total body irradiation 9 - 10 Gy (sTBI) or Bu 16 mg/kg of Mel 140 - 180 mg/m(2) + Ara-c 2 - 4 g/m(2).
Results: All patients reconstituted hematopoiesis. The median follow-up duration was 504 (18-3043) days. Transplant-related mortality was 10%. The probabilities of 3 year disease-free survival (DFS) for ALL in CR(1) and CR(2) were 67.7% +/- 10.3% and 16.7% +/- 15.2%, respectively (P = 0.00547); the 3 year DFS was significantly better with posttransplant treatment than without it (92.3% +/- 7.4% vs 50.0% +/- 17.7%, P = 0.0130).
Conclusion: Acute lymphoblastic leukemia patients without HLA-matched related donor are recommended for ASCT in CR(1). To reduce relapse and improve the outcome, adoptive immunotherapy or maintenance chemotherapy should be given after ASCT.