造血干细胞移植治疗成人急性白血病

造血干细胞移植治疗成人急性白血病5例，包括3例第一次完全缓解（CR1）急性粒细胞白血病，1例CR1急性淋巴细胞自血病，1例急性粒细胞白血病复发。其中异基因骨髓移植（alloBMT）4例，同基因外周血造血干细胞移植（Syn－PBSCT）1例。所有病例均采用TBI＋CY＋CCNU作预处理。所有病例均移植成功。2例发生急性移植物抗宿主病（aGVHD），其中1例又发生慢性GVHD。1例未缓解患者移植后完全缓解，但于 69天死于间质性肺炎；3例已分别无病生存22、10和3个月；余1例（急淋）移植后12个月死于复发。结果尚提示外周血干细胞移植造血重建更快。     

供者淋巴细胞输注联合化疗治疗异基因造血干细胞移植后白血病复发的疗效观察

目的 观察供者淋巴细胞输注(DLI)联合化疗治疗异基因造血干细胞移植(Allo-HSCT)后白血病复发的疗效。方法 对Allo-HSCT后白血病复发的4例患者予分次逐渐提高单次剂量方案(EDR．)的DLI联合化疗治疗，观察白血病血液学完全缓解(CR)率、无病生存(DFS)率、移植物抗宿主病(GVFtD)和骨髓抑制发生率。结果 4例均获得血液学CR，CR率100％，STR-PCR测定证实恢复为供者基因型；随访70d～14个月，1例DLI后50天发生慢性GVHD，发生率25％,无1例发生急性GVHD、全血细胞减少和骨髓抑制，3例无病生存(DFS)，1例于DLI后70天死于CMV性间质性肺炎。随访至今，3例DFS患者血象和骨髓象一直正常。结论 EDR DLI联合化疗治疗Allo-HSCT后白血病复发，疗效显著,副作用小,应用安全。     

移植物抗宿主病预防性治疗研究进展

移植物抗宿主病(GVHD)是异基因造血干细胞移植后长期存在的严重问题,产生GVHD的免疫应答是涉及供者T细胞和自然杀伤细胞(NK)与受者特异细胞相互作用的一个复杂过程,是由细胞因子和淋巴细胞——靶细胞相互作用共同介导的,并可导致多脏器损伤。通过单克隆抗体、基因治疗．细胞治疗、疫苗等生物学方法可选择性去除引起GVHD的细胞或诱导建立同种异体特异性移植耐受。有效提高移植后生存率．改善生存质量．成为造血干细胞移植研究的活跃领域。     

异基因造血干细胞移植治疗复发难治性淋巴瘤的临床研究

目的 探讨异基因造血干细胞移植(allo-HSCT)治疗复发难治性淋巴瘤的疗效和安全性.方法 北京军区总医院血液科2007年1月至2012年1月应用allo-HSCT共治疗7例复发难治性淋巴瘤患者,其中男4例,女3例,年龄18～ 48岁,平均年龄33.7岁.原发病为非霍奇金淋巴瘤6例,其中弥漫大B细胞淋巴瘤(DLBCL)2例,T淋巴母细胞淋巴瘤(T-LL)1例,皮肤结外鼻型NK/T细胞淋巴瘤(ENKTCL-N)1例,肝脾T细胞淋巴瘤(HSTCL)1例,伯基特淋巴瘤(BL)1例;霍奇金淋巴瘤1例,为混合细胞型.首次复发4例,2次及以上复发2例,原发难治1例;自体移植后复发2例(均为2次及以上复发者);移植时有3例缓解,4例未取得缓解.供受者HLA全相合3例,HLA不全相合4例,采用骨髓加外周血干细胞联合移植,预处理均采用氟达拉滨替代环磷酰胺(Cy)的改良白消安(Bu)+Cy方案,移植物抗宿主病(GVHD)的预防采用经典环孢素(CsA)和甲氨蝶呤(MTX),移植后观察患者并发症和无病生存等情况.结果 6例患者能较好耐受预处理方案,均获造血重建,植入证据检测证实100％为完全供者造血,1例预处理后死亡.全部患者中位随访29.6个月(1～70个月).共5例发生急性GVHD,4例发生慢性GVHD;死亡2例(因感染死亡1例、复发死亡1例),其余5例患者无病生存,无病生存率为71.4％,最长无病生存时间已达70个月.结论 allo-HSCT治疗复发难治性淋巴瘤安全有效,可作为挽救治疗的关键技术,可在临床广泛开展.     

单倍型异基因造血干细胞移植治疗儿童复发难治性急性淋巴细胞白血病的临床研究

目的 探讨单倍型异基因造血干细胞移植(allo-HSCT)治疗儿童复发难治性急性淋巴细胞白血病(ALL)的疗效和安全性.方法 选择北京军区总医院血液科2010年1月至2013年1月采用allo-HSCT治疗的儿童复发难治性ALL患者20例,其中男12例,女8例,中位年龄9岁(1～ 14岁);B-ALL 14例,T-ALL 6例;移植时复发未缓解10例,复发后取得2次或者3次缓解10例;6例采用骨髓加外周血干细胞联合移植,14例仅采用外周血干细胞移植;预处理方案主要为白消安、氟达拉滨、环磷酰胺、抗胸腺细胞免疫球蛋白,部分患儿加用阿糖胞苷、依托泊苷或司莫司汀及接受全身照射等.移植物抗宿主病(GVHD)的预防采用环孢素、吗替麦考酚酯、甲氨蝶呤(+1、+3、+6、+11天).移植后观察患儿不良反应、并发症和无病生存等情况.结果 全部患儿均获重建造血,移植后1个月供者细胞嵌合率均为100％.移植后粒细胞植活中位时间为12.5d(9～23d),血小板植活中位时间为15d(12～40d).随访至2014年6月,中位随访时间25个月(2 ～ 50个月),8例发生急性GVHD,11例发生慢性GVHD,因GVHD死亡2例,感染死亡1例,复发死亡2例,共死亡5例,其余15例患儿生存,全组患者的总体生存率为75％.结论 单倍型allo-HSCT治疗儿童复发难治性ALL安全可行,长期生存率提高,移植后并发症及复发率并未增加.     

减低强度预处理异基因造血干细胞移植治疗老年人复发难治性急性髓系白血病的临床研究

目的 探讨减低强度预处理异基因造血干细胞移植（allo-HSCT）治疗老年人复发难治性急性髓系白血病（AML）的疗效和安全性.方法 采用减低强度预处理的allo-HSCT治疗北京军区总医院2012年1月至2014年1月收治的6例老年人复发难治性AML,其中男5例,女1例,年龄61～68岁,平均年龄64.6岁,供者接受粒细胞集落刺激因子动员,均采用外周血干细胞移植,预处理方案为降低预处理强度的氟达拉滨联合白消安注射液（商品名：白舒非）、阿糖胞苷及环磷酰胺等,移植物抗宿主病（GVHD）预防采用联合免疫抑制剂,移植后3个月进行预防性供者外周血干细胞输注,观察全部患者不良反应、GVHD和无病生存等情况.结果 全部患者获造血重建,中性粒细胞≥0.5×109/L及血小板计数≥20×109/L的平均时间分别为21.5 d及24.2 d,植入证据检测证实为100％为完全供者造血.中位随访18.5个月（5～30个月）,共3例发生GVHD,GVHD死亡1例,复发死亡2例,复发时间为11.5个月（5～ 18个月）,其余3例患者仍无病生存,2年的无病生存率为50％,最长无病生存时间已达30个月.结论 减低强度预处理的allo-HSCT是复发老年人AML挽救性治疗的可行方法.     

异基因造血干细胞移植后白血病复发的危险因素

目的探讨异基因造血干细胞移植后白血病复发的危险因素。方法回顾性选择71例行异基因造血干细胞移植术的白血病患者,采用单因素、COX多因素回归法分析71例患者性别、年龄、疾病类型、诱导疗程数、初诊白细胞计数、巨细胞病毒感染、移植物来源、供受者HLA配型、急性移植后移植物抗宿主病、慢性移植后移植物抗宿主病与复发的相关性。结果71例患者中14例复发。单因素分析结果表明,初诊白细胞计数、诱导疗程数、移植物来源及慢性移植物抗宿主病史是异基因造血干细胞移植后复发的危险因素,P<0.05;Cox多因素回归分析结果表明,诱导疗程数多、无慢性移植物抗宿主病是异基因造血干细胞移植后复发的独立危险因素,P<0.05。结论无慢性移植物抗宿主病、诱导疗程数多是异基因造血干细胞移植后复发的危险因素。     

自身造血干细胞移植术联合小剂量白介素-2治疗16例恶性淋巴系统肿瘤

目的评价自体外周血造血干细胞移植(Auto-PBSCT)联合小剂量白介素-2(IL-2)在恢复细胞免疫,从而减少淋巴系统恶性肿瘤(ALL和NHL)移植后的高复发率和提高无病生存率中的作用.方法采用化疗联合短程小剂量G-CSF的动员方法,收集自体外周血造血干细胞,对16例成人淋巴源性恶性血液肿瘤(7例CR1ALL、3例CR1 NHL、5例难治性NHL和1例CR2 ALL)进行移植,使用IL-2对移植物进行温育,移植术造血恢复过程中使用IL-2和造血恢复后长期小剂量使用IL-2 5万U/d.结果ALL 7例CR1,现仍存活,平均生存时间达73个月,中位生存期为51.5个月,3例CR1 NHL2例仍存活,10例CR1恶性淋巴系肿瘤的6年无病生存率达0.90±0.11,其95%CI为0.71～0.99.而难治性NHL和CR2-ALL,1例至今仍无病生存达63月.1例淋巴母细胞IV期NHL生存达46个月后复发死亡.这组3年无病生存率只有0.33±0.18, 95%CI 0.02～0.64,平均生存时间只有20.66个月,中位生存期为6个月.结论通过小样本Auto-PBSCT联合长期小剂量IL-2可能有效地提高CR1淋巴系恶性肿瘤无病生存率.     

外周血造血干细胞移植治疗恶性血液病53例

背景与目的:造血干细胞移植使恶性血液病的预后得到很大的改观,外周血造血干细胞移植(transplantation of peripheral blood stem cells,PBSCT)逐渐取代了骨髓移植(bone marrow transplantation,BMT)而成为造血干细胞移植的主要方式.本研究观察了自体或异基因外周血造血干细胞移植对53例恶性血液病患者的治疗效果.方法:53例恶性血液病患者于2003年7月～2006年5月在郑州大学第一附属医院血液科接受PBSCT治疗,中位年龄37岁.采用G-CSF或化疗联合G-CSF动员外周血干细胞.自体移植患者接受CD34 细胞的中位数为3.0×106/kg,异基因移植患者接受CD34 细胞的中位数为6.2×106/kg;自体移植采用MAC预处理方案,异基因移植采用改良的Bu/Cy预处理方案;移植物抗宿主病(graft versus host disease,GVHD)的预防采用MTX、环孢菌素A联合骁悉,1例1个点不合患者加用抗淋巴细胞球蛋白.结果:移植后中性粒细胞≥0.5×109/L、血小板≥20×109/L的天数在自体移植中分别为13天和19天,在异基因移植中分别为12天和15天;异基因移植中Ⅰ～Ⅲ度急性GVHD(aGVHD)的发生率为31.4%,慢性GVHD(cGVHD)的发生率为71.4%,复发率在自体移植和异基因移植患者中分别为38.9%和5.7%,700天无病生存率在自体移植和异基因移植患者中分别为57.9%和69.5%.结论:自体和异基因外周血造血干细胞移植均能很快地重建造血,是治疗恶性血液病的重要手段之一.     

含全身照射方案的造血干细胞移植对难治性白血病的疗效

目的探讨含全身照射(TBI)预处理方案的造血干细胞移植(allo-HSCT)对难治性白血病的疗效和安全性。方法采用含TBI预处理方案的allo-HSCT治疗20例难治性白血病患者,采用骨髓加外周血干细胞联合移植,预处理方案包括阿糖胞苷、氟达拉滨及TBI等,全身照射采用6MV-X照射,移植物抗宿主病(GVHD)预防采用经典环孢菌素A(CSA)和氨甲蝶呤(MTX)及抗胸腺细胞免疫球蛋白(ATG)、CD25单克隆抗体,移植后观察并发症和患者无病生存等情况。结果 20例患者均获造血重建,植入证据检测证实100%为完全供者造血。TBI后患者有轻度恶心、呕吐、腮腺肿胀等症状,无1例发生间质性肺炎。中位随访时间为12.5个月(6～36个月),共8例发生GVHD,死亡2例;因感染死亡2例、复发死亡6例,其余10例患者仍无病生存,2年无病生存率为50%。结论含全身照射方案的造血干细胞移植,对难治性白血病是1种安全有效的治疗方案,可作为挽救治疗的关键技术。广泛应用于临床。     

异基因造血干细胞移植治疗急性T 淋巴细胞白血病和淋巴瘤：附50例临床报告

目的 探讨异基因造血干细胞移植（allogeneic hematopoietic stem cell transplantation,allo-HSCT）治疗急性T淋巴细胞白血病（T cell acute lymphoblastic leukemia,T-ALL）和急性T淋巴母细胞淋巴瘤（T cell acute lymphoblastic lymphoma, T-LBL）的疗效及预后。方法 回顾性分析2014—2019年于航天中心医院接受allo-HSCT的50例T-ALL/LBL患者的临床资料,分析其临床疗效、并发症及预后。结果 50例患者中男性41例,女性9例,中位年龄20.5岁（范围：9.0~63.0岁）;单倍体移植44例,脐血移植 2例,同胞全合移植 4例;T-ALL 40例,T-LBL 10例;移植前处于完全缓解（CR）状态16例,处于未完全缓解（非CR）状态34例。移植后,中位随访20个月（范围：1~84个月）,存活23例,死亡27例;移植后24个月的总生存率和无复发生存率分别为50.0%和44.0%,36个月的总生存率和无复发生存率分别为45.5%和40.0%。随访期间,共有20例患者复发,复发率为40.0%（20/50）。移植前获CR、无髓外病变、无中枢神经系统受累的患者预后较好,而移植前有无基因突变、不同预处理方案、有无急性/慢性GVHD患者的总生存期及无复发生存期组间比较差异无统计学意义（均P>0.05）。结论 在这项小样本、无对照的临床研究中,T-ALL/LBL患者在缓解期行allo-HSCT可能较挽救性移植的生存预后有所改善,其中复发为移植失败的主要原因。     

A higher incidence of relapse for acute lymphocytic leukemia treated with allogeneic hematopoietic stem cell transplantation conditioned with BU-CY<Subscript>2</Subscript> regimen

Objective: To analyze long-term outcome in sixty leukemia patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT) following busulfan and cyclophosphamide (BU-CY2) between 1994 and 2000.Methods: BU-CY2 was used as the conditioning regimen and allo-HSCT was performed for all patients. All the patients were followed-up until August 2001 or death. The leukemia-free survival, relapse and transplant-related mortality were discussed. Results: All 60 patients had sustained engraftment. Acute GVHD occurred in 22 out of 60 patients (36.7%), and the incidence of acute GVHD was 48% in the patients with CML, 30% in AML and 26.7% in ALL. 38 patients are still alive in continuous remission with a median follow-up of 30 months (range 12-84) and 22 patients have died. The main causes of death were acute GVHD in 3 patients, CMV-IP in 7 patients and relapse in 11 patients,the remaining one died of pulmonary infection. Among 11 patients who died of relapse, 8 patients with ALL relapsed in the early stage post transplant (8115, 53.3%), relapse was observed in the remaining 3 patients with AML, and however, no relapse was observed in CML. The probability of disease-free survival at 3 years for CML. AML and ALL patients was 80%, 70% and 26.7%, respectively.Conclusion: This results suggests that BU-CY2 is an effective conditioning regimen in patients with AML and CML, resulting in a low relapse rate and high long-term survival rate, but not as effective in patients with ALL, with a higher incidence of relapse and therefore, not recommended for ALL patients.     

Second Allogeneic Transplantation for Relapsed Acute Leukemia after Initial Allogeneic Hematopoietic Stem Cell Transplantation

We retrospectively reviewed the medical records of 45 patients with relapsed acute leukemia after initial allogeneic hematopoietic stem ell transplantation (allo-HSCT). Among 45 patients, a total of 11 patients eventually underwent second allo-HSCT (HSCT-2). Median survival after relapse was 294?days (range, 135-942?days) for HSCT-2. Multivariate analysis showed significantly better survival for recipients of second allo-HSCT than for other patients (hazard ratio, 4.38; 95?% confidence interval, 1.45-13.2; P?=?0.009). Although outcomes for patients with relapsed leukemia were generally poor, our results suggest that second HSCT could offer a survival advantage over other conventional salvage strategies.     

异体淋巴细胞输注防治白血病移植后复发的疗效及安全性分析

  目的  探讨异体淋巴细胞输注防治白血病造血干细胞移植(HSCT)后复发的疗效及安全性。   方法  回顾性研究2000年2月至2010年4月间在南方医科大学珠江医院行HSCT后进行异体淋巴细胞输注的35例白血病患者, 包括20例自体造血干细胞移植(Auto-HSCT)患者和15例异基因造血干细胞移植(Allo-HSCT)患者。   结果  35例患者3年总生存(OS)率为43.3%, 3年无病生存(DFS)率为38.9%。Auto-HSCT患者行异体淋巴细胞输注患者的3年OS为63.2%, 3年DFS为55.0%。而Allo-HSCT患者复发后行治疗性输注的患者完全缓解率(CR)仅为35.7%, 3年OS为10.0%。患者死亡原因主要是疾病复发(17例)、骨髓抑制(1例)及急性GVHD(1例)等。   结论  异体淋巴细胞输注是防治移植后复发的有效方法, 高复发风险的患者行预防性输注有望提高生存期, 且异体淋巴细胞输注相关副作用无明显增加。       

Effect of graft-versus-host disease on the outcome of bone marrow transplantation from an HLA-identical sibling donor using GVHD prophylaxis with cyclosporin A and methotrexate.

The effect of graft-versus-host disease (GVHD) on relapse incidence and survival has been analyzed in several studies, but previous studies included heterogeneous patients. Therefore, we analyzed the data of 2114 patients who received unmanipulated bone marrow graft from an HLA-identical sibling donor with a GVHD prophylaxis using cyclosporin A and methotrexate. Among the 1843 patients who survived without relapse at 60 days after transplantation, 435 (24%) developed grade II-IV acute GVHD. Among the 1566 patients who survived without relapse at 150 days after transplantation, 705 (47%) developed chronic GVHD. The incidence of relapse was significantly lower in patients who developed acute or chronic GVHD, but disease-free survival (DFS) was significantly inferior in patients who developed acute GVHD. A benefit of 'mild' GVHD was only seen in high-risk patients who developed grade I acute GVHD. The strongest association between GVHD and a decreased incidence of relapse was observed in patients with standard-risk acute myelogenous leukemia/myelodysplastic syndrome. In conclusion, the therapeutic window between decreased relapse and increased transplant-related mortality due to the development of GVHD appeared to be very narrow.     

Cladribine- and decitabine-containing conditioning regimen has a low post-transplant relapse rate in patients with relapsed or refractory acute myeloid leukemia and high-risk myelodysplastic syndrome

To reduce the risk of relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT), there have been continuing efforts to optimize the conditioning regimens. Our study aimed to analyze the risk factors associated with the relapse of relapsed/refractory (R/R), high-risk acute myeloid leukemia (AML) and high-risk myelodysplastic syndrome (MDS) post-transplant and the efficacy of a new conditioning regimen involving decitabine and cladribine. Clinical data of 125 patients with R/R AML, high-risk AML and high-risk MDS who underwent allo-HSCT were collected. In addition, 35 patients with R/R AML, high-risk AML and high-risk MDS received treatment with a new conditioning regimen including decitabine and cladribine. Cox regression analysis was used to identify risk factors associated with OS, RFS and relapse. Among 125 patients who underwent allo-HSCT, CR before allo-HSCT and matched sibling donors were independent protective factors for OS. DNMT3A abnormality was an independent risk factor for both relapse and RFS. Among 35 patients who received a new conditioning regimen containing decitabine and cladribine, only six patients relapsed and 1-year cumulative incidence of relapse was 11.7%. Moreover, this new regimen showed efficient MRD clearance early after allo-HSCT. The combined decitabine- and cladribine-based conditioning regimen showed a low relapse rate and a high survival without an increased incidence of GVHD or adverse effects and thus has potential for use in allo-HSCT for R/R AML, high-risk AML and high-risk MDS.     

Clinical Outcome of Hematopoietic Stem Cell Transplantation for Philadelphia Chromosome-Positive Acute Lymphoblastic Leukemia (Ph + ALL): Experience From a Single Institution

To identify factors affecting transplant outcome, data from 65 Philadelphia Chromosome-positive acute lymphoblastic leukemia (Ph + ALL) patients who had undergone allogeneic hematopoietic transplantation (allo-HSCT) in our institution were analyzed. The probability of OS (overall survival) and DFS (disease free-survival) at 3 years after allo-HSCT was 40.1 % and 38 %, respectively. Multivariate analysis showed that gender and disease status (p?=?0.0059, p?=?0.0039, respectively) were significant factors for OS. Among 51 patients with CR (complete remission), multivariate analysis showed that the factors associated with OS included gender (p?=?0.014), number of white blood cell at diagnosis (p?=?0.025), and the source of stem cells (bone marrow <BM >versus. cord blood; BM stem cell source was associated with favorable OS, p?=?0.042). Twenty-one patients relapsed after allo-HSCT with a median of 207 days (range, 19–1,324 days). The estimated cumulative incidence of relapse at 3 years was 39.4 %. Patients with CR showed a lower relapse rate at 3 years (34.2 %) when compared with patients with non-CR (62.7 %). Among 21 patients, eight patients received imatinib-based chemotherapy and 13 received chemotherapy without imatinib before HSCT. In terms of treatment after relapse, seven patients received chemotherapy with imatinib and 13 received chemotherapy without imatinib. Five patients underwent a second HSCT. One patient survived, and 20 patients died. In this study, disease status at time of allo-HSCT had a significant impact on OS, DFS, and relapse. Imatinib administration given before allo-HSCT was not associated with favorable outcome. Second-generation tyrosine kinase inhibitors may be more suitable candidates for Ph + ALL before and after allo-HSCT.     

Hematopoietic Stem Cell Transplantation for Patients with Chronic Myeloid Leukemia

OBJECTIVE To evaluate the effects of autologous and allogeneic hematopoietic stem cell transplantation (HSCT) for patients with chronic myeloid leukemia(CML).METHODS Fifty-seven patients with CML were treated by HSCT, including 8 cases treated with autologous transplantation purged in vivo and in vitro of minimal residual disease (MRD), 39 cases with related donor allogeneic HSCT (allo-HSCT) and 10 cases with unrelated donor alIo-HSCT. The conditioning regimen was a TBI (total-body irradiation) CY (cyclophosphamide, CTX) protocol in 32 patients, a modified BuCY (hydroxyurea, busulfan, Ara-C, CTX) protocal in 24 patients, and a MACC ( Melphalan, Ara-C, CTX and chlorethyl cyclohexyl nitrosourea ) protocol in one patient. Cyclosporine (CsA) and methotrexate (MTX) were used in patients with related-donor allo-HSCT, and CsA and MTX were added to mycophenolate mofetil (MMF) and antithymocyte globulin (ATG) in unrelated donor allo-HSCT for graft versus host disease (GVHD) prophylaxis. Otherwise, CsA was only used for GVHD prophylaxis in patients with accelerated phase (AP) and blast crisis (BC). The Kaplan-Meier survival analysis model was used to estimate the overall survival (OS) and the disease-free survival (DSF) at 5 years after transplantation.RESULTS Eight patients with autologous transplantation, except for 1 case who died of transplantation-related complications, obtained cytogenetic part or complete remission (CR) within 3 months after transplantation. One patient, who was in BC and obtained CR in hematology before transplantation, had been in molecular CR for 92 months after autologous transplantation. Among the 49 patients treated with alIo-HSCT, all obtained CR, except for one patient who died of hepatic veno-occlusive disease (VOD) and one who had not obtained CR. The incidence of infection and VOD was 33.3% and 7.0%, respectively, during transplantation. After transplantation the incidence of hemorrhagic cystitis (HC) and cytomegalovirus (CMV) interstitial pneumonia (IP) was 22.8% and 8.8%, respectively. VOD, HC and CMV IP did not occur in patients with autologous transplantation. The incidence of acute GVHD and the frequency of chronic GVHD was 41.0% and 48.6%, respectively, in patients with related and unrelated transplantation. The rate of relapse in patients with autologous and allogeneic transplantation was 57.1% and 12.8%, respectively. The DFS at 5 years after transplantation was 25.0% and 61.7%, respectively, in patients with autologous and related donor transplantation. The DFS at 5 years was 70.7% and 34.1%, respectively, in patients with CP (chronic phase) or AP and BC before transplantation.CONCLUSION AIIo-HSCT may have a higher clinical cure rate for CML patients with CP. The CsA MTX MMF ATG protocol is more effective for acute GVHD prophylaxis and can decrease the incidence and degree of GVHD in patients with unrelated donor transplantation, Autologous transplantation with purged bone marrow can prolong the survival time of CML patients and some may be cured with transplants of this type.