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Objective To explore the secondary transplantation strategy for graft failure of the primary haploidentical hematopoietic stem cell transplantation (haplo-SCT) associated with fatal complications in a patient with acute T-cell lymphocytic leukemia. Methods One male patient was diagnosed with acute T-cell lymphocytic leukemia. In November 2015, he received haplo-SCT from his sister as the donor. But graft failure was developed and complicated by Escherichia coli sepsis, serum disease, hepatic venous occlusion and multiple organ failure. At 32nd d after the first transplantation, secondary haplo-SCT from his father as the donor was performed. Prior to secondary transplantation, chemotherapy pretreatment was not conducted. Post-transplantation cyclophosphamide (PTCy)-based prevention measure against the graft-versus-host disease (GVHD) was adopted after transplantation. Results White blood cells were implanted on the 12nd d and platelet implantation was performed on the 67th d after haplo-SCT. Serum disease, septicemia and hepatic venous occlusion were cured and organ function was improved. However, the patient died from the recurrence of leukemia at 18th months after transplantation (June 2017). Conclusions Prior to secondary haplo-SCT, PTCy prevention measures against the GVHD rather than pretreated chemotherapy probably contributes to the success of transplantation. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of unrelated cord blood transplantation (UCBT) on the treatment of high-risk childhood and adult acute leukemia. Methods Ten patients with high-risk acute leukemia underwent UCBT. Among the 10 patients, 3 were children and 7 were adults with the median age of 29 years old (11-41 years old). Six patients underwent one-unit cord blood transplantation and four patients underwent two-unit cord blood transplantation. The myeloablative conditioning regimen without antithymocyte globulin (ATG) was adopted. Cytarabine (Ara-C), fludarabine (Flu) or total body irradiation (TBI)was added on the basis of busulfan (Bu) and cyclophosphamide (Cy). Ciclosporin and mycophenolate mofetil were used to prevent graft-versus-host disease (GVHD). Results The transplantation was successful in 8 (80%) patients. The median implant-time of leukocytes was 19 d (1 4-25 d) and that of platelets was 40 d (33-60 d). Three patients developed acute GVHD and no patient developed chronic GVHD. The median follow-up time was 24 months (1 -29 months). Seven patients remained in disease-free survival. Both the 2-year overall survival and disease-free survival rates were 66.7%. Conclusions UCBT is feasible in the treatment of high-risk acute leukemia. UCBT is the preferred option for the high-risk patients without HLA-identical sibling donors, which is characterized by low incidence of GVHD and low recurrence rate. It may make patients with acute leukemia remain long-term survival. [ABSTRACT FROM AUTHOR]