The consensus on the monitoring, treatment, and prevention of leukemia relapse after allogeneic hematopoietic stem cell transplantation in China

Cancer Lett. 2018 Dec 1:438:63-75. doi: 10.1016/j.canlet.2018.08.030. Epub 2018 Sep 11.

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an important curative therapy for patients with leukemia. However, relapse remains the leading cause of death after transplantation. In recent years, substantial progress has been made by Chinese physicians in the field of establishment of novel transplant modality, patient selection, minimal residual disease (MRD) monitoring, and immunological therapies, such as modified donor lymphocyte infusion (DLI) and chimeric antigen receptor T (CART) cells, as well as MRD-directed intervention for relapse. Most of these unique systems are distinct from those in the Western world. In this consensus, we reviewed the efficacy of post-HSCT relapse management practice from available Chinese studies on behalf of the HSCT workgroup of the Chinese Society of Hematology, Chinese Medical Association, and compared these studies withthe consensus or guidelines outside China. We summarized the consensus on routine practices of post-HSCT relapse management in China and focused on the recommendations of MRD monitoring, risk stratification directed strategies, and modified DLI system. This consensus will likely contribute to the standardization of post-HSCT relapse management in China and become an inspiration for further international cooperation to refine global practices.

Keywords: Acute leukemia; Donor lymphocyte infusion; Minimal residual disease; Myelodysplastic syndrome; Targeted therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Asian People
  • China
  • Consensus
  • Gene Expression Regulation, Leukemic
  • Hematopoietic Stem Cell Transplantation / methods*
  • Hematopoietic Stem Cell Transplantation / statistics & numerical data
  • Humans
  • Leukemia / ethnology
  • Leukemia / prevention & control
  • Leukemia / therapy*
  • Monitoring, Physiologic / methods*
  • Monitoring, Physiologic / statistics & numerical data
  • Neoplasm, Residual / ethnology
  • Neoplasm, Residual / genetics
  • Neoplasm, Residual / prevention & control
  • Recurrence
  • Secondary Prevention / methods*
  • Survival Analysis
  • Transplantation Conditioning / methods
  • Transplantation, Homologous