Decitabine in Haploidentical Hematopoietic Stem Cell Transplantation for Treatment Refractory Acute Monocytic Leukemia and Literature Review

Objective To investigate the feasibility and efficacy of decitabine (DAC) bridge therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with refractory acute monocytic leukemia (AML).Methods In November 2011,a case of refractory acute AML who admitted by the First Affiliated Hospital of Chinese PLA General Hospital was included in this study.This patient recived 7 kinds of chemotherapy regimens,and then underwent with DAC bridge therapy and busulfan combined cyclophosphamide (BUCY) regimen before haploidentical HSCT (haplo-HSCT).The clinical data of this patient were analyzed retrospectively,and its related literatures were reviewed.The clinical protocol and consent forms were approved by the institutional review board for human investigation at the First Affiliated Hospital of Chinese PLA General Hospital.Patient provided written informed consent for inclusion in the study.Results With DAC bridge therapy,this patient achieved successful engraftment and experienced only grade Ⅰ actue graft-versus-host disease (aGVHD) and limited chronic GVHD (cGVHD).This patient achieved full donor chimerism (FDC) and didn't monitor minimal residual disease (MRD) in 1,6,12 and 24 months after HSCT.Until now,he was in 25 months progression-free survival (PFS) and no relapse.Conclusions DAC bridge therapy followed by haplo-HSCT is safe and feasibility for the patient with multidrug resistance (MDR) and refractory AML,which could reduce the relapse efficiently and prolong life-span of the patients. Key words: Decitabine;  Hematopoietic stem cell transplantation;  Bridge therapy;  Leukemia, monocytic, acute