【摘要】 目的分析急性髓细胞白血病患者接受同胞全相合异基因造血干细胞移植的疗效。方法回顾性分析2008年1月至2017年12月在该院接受同胞异基因造血干细胞移植的121例急性髓细胞白血病患者的临床资料。采用白消安+环磷酰胺(BU/CY)、改良BU/CY+阿糖胞苷或去甲氧柔红霉素+BU/CY预处理方案,移植物抗宿主病治疗方案采用环孢素+甲氨蝶呤+吗替麦考酚酯,所有患者输注外周血干细胞或骨髓联合外周血干细胞。结果 121例患者中120例植入,中性粒细胞植入中位时间为11d,血小板植入中位时间为14d。Ⅱ～Ⅳ度急性移植物抗宿主病发生率为8.3%,慢性移植物抗宿主病发生率为23.0%。3年复发率为24.0%,移植前缓解组和未缓解组移植后复发率分别为15.9%和51.8%,移植前未缓解组复发率明显高于移植前缓解组(P<0.01)。所有患者3年预期总生存率和无病生存率分别为63.0%±3.4%和62.0%±1.8%,移植前缓解组和未缓解组患者3年预期总生存率为72.3%±13.1%和33.3%±11.4%,3年预期无病生存率分别为71.3%±10.7%和29.6%±3.3%;无论总生存率还是无病生存率,移植前缓解组均高于未缓解组(P<0.01)。结论同胞异基因造血干细胞移植是治疗急性髓细胞白血病的一种有效方法,应尽量争取在白血病缓解期行异基因造血干细胞移植。更多还原

【Abstract】 Objective To analyze the efficacy of siblings totally compatible allogeneic hematopoietic stem cell transplantation(Allo-HSCT)for treating acute myelogenous leukemia.Methods The clinical data in 121 cases of acute myelogenous leukemia in this hospital from January 2008 to December 2017 receiving siblings Allo-HSCT were retrospectively analyzed.The preprocessing regimens including busulfan+cyclophosphamide(BU/CY),modified BU/CY+cytarabine or idarubicin+BU/CY were adopted.The graft-versus-host disease scheme adopted cyclosporine+ methotrexate+ mycophenolate mofetil.All patients received transfusion of peripheral blood stem cells(PBSC)or bone marrow combined PBSC.Results Among 121 cases,there were 120 cases of engraftment.The median time of neutrophil engraftment and platelet engraftment were 11 d and 14 drespectively.The incidence rate of gradeⅡ-Ⅳ acute graft versus host disease was 8.3%.The incidence rate of chronic graft versus host disease was 23.0%.The 3-year relapse rate was 24.0%.The relapse incidence rates in the patients with complete remission and non-complete remission before transplantation were15.9%and 51.8% respectively.The relapse incidence rate in the complete remission group was higher than that in the non-complete remission group(P<0.01).The 3-year estimated overall survival(OS)rate and disease-free survival(DFS)rate were 63.0%±3.4%and 62.0%±1.8%respectively.The 3-year estimated over survival rates before transplantation were 72.3% ±13.1% and 33.3% ±11.4%in the complete remission group and non-complete remission group respectively.The 3-year estimated disease-free survival rates were71.3%±10.7%and 29.6%±3.3%.The OS and DFS before transplantation in the complete remission group were higher than those in the non-complete remission group(P<0.01).Conclusion Siblings Allo-HSCT is an effective method for treating acute myelogenous leukemia.Try to conduct Allo-HSCT in leukemia remission stage.更多还原