[Clinical investigation of refractory lymphoma with HLA-mismatched stem-cell microtransplantation].

Objective To explore the efficacy and safety of HLA-mismatched stem-cell microtransplantation in patients with refractory lymphoma. Methods This study included 10 patients with relapsing or refractory lymphoma at Department of Hematology, Second Artillery General Hospital from October 2009 to February 2012.All patients received programmed infusions of G-CSFmobilized HLA-mismatched donor peripheral blood stem cell (G-PBSC) after each cycle of Hyper-CVAD/MA conditioning without graft-versus-host disease (GVHD) prophylaxis. Results A total of 31 cycles of microtransplantation were performed.Among them, 6 patients achieved a complete remission (CR) and 2 got partial remission (PR).And the overall response was 8/10.The occurrence of gradesⅢ-Ⅳ neutrocytopenia and thrombocytopenia was almost 100% after Hyper-CVAD/MA conditioning, but the median recovery times of neutrophils and platelets were 9 days and 14 days respectively because of programmed infusions of G-PBSCs.And 18 bouts of G-PBSC infusion related fever were observed.No GVHD was observed in any of them during treatment.Up to March 2013,6 patients survived while another 4 died.The 1- and 3-year overall survival and disease-free survival rates were the same (60%). Conclusion The novel therapy of microtransplantation may improve outcome and avoid GVHD in patients with relapsing or refractory lymphoma. Key words: Lymphoma; Peripheral blood stem cell transplantation; Lymphoma, large Bcell, diffuse; Composite lymphoma