自体外周血干细胞移植联合生物治疗及长间歇维持化疗序贯治疗成人急性非淋巴细胞白血病的临床研究  

Clinical study on auto - peripheral blood stem cell transplantation with biotherapy and long - interval maintenance therapy in adult acute nonlymphoblastic leukemia

作　　者：张诚[1] 陈幸华[1] 张曦[1] 高蕾[1] 刘林[1] 孔佩艳[1] 刘红[1] 彭贤贵[1] 王武[1] 王庆佘[1] 

机构地区：[1]第三军医大学新桥医院血液科,重庆400037

出　　处：《中国医师杂志》2007年第10期1297-1300,共4页Journal of Chinese Physician

基　　金：重庆市医学重点学科建设基金资助项目（2006C028）

摘　　要：目的评价大剂量化疗、自体外周血干细胞移植、生物治疗,长间歇维持化疗序贯治疗成人急性非淋巴细胞白血病（ANLL）的疗效。方法32例成人急性非淋巴细胞白血病患者首次缓解并经3个周期大剂量阿糖胞苷强化治疗后,行自体外周血干细胞移植,预处理方案采用MAC、CEAC等,造血重建后予以大剂量IL-2生物治疗4个疗程,之后每3~4个月予以长间歇化疗1次,共维持2年,常用方案包括TA、MA、HEA等。结果32例患者移植后均成功重建造血,无一例移植相关死亡。长间歇维持化疗满2年的12例中,有8例存活;存活中位时间为确诊后1268（953-1926）d,移植后986（725-1742）d,平均生存时间为1475.7 d,3年无病存活率为（66.7±8.1）%;其余维持化疗还未到2年的20例患者中,有2例复发（10.0%）,其中1例死亡（5.0%）,其余18例至今病情稳定。结论大剂量化疗、自体外周血干细胞移植、生物治疗、长间歇维持化疗序贯治疗成人急性非淋巴细胞白血病,治疗相关死亡率低,无病生存率较高,可作为改善成人ANLL治疗效果的重要措施。Objective To evaluate the clinical efficacy of high - dose hemotherapy, auto - peripheral blood stem cell transplantation （auto- PBSCT） and long -interval maintenance therapy in adult acute nonlymphoblastic leukemia （ANLL）. Methods Thirty -two adult ANLL patients received auto-PBSCT after first remission induction and three courses high-dose Ara - e treatment. After auto-PBSCT, patients received high dose IL-2 （100WU/d） treatmemt for 28 days and long-interval maintenance therapy per 3 -4 months. MAC and CEAC are the frequently used treatment prescription. Results Thirty-two adult ANLL patients had rapid hematopoietie reeonstitution after auto-PBSCT. There was no hematopoietic stem cell transplantation related death. After two years of long-interval maintenance therapy, eight of twelve patients were alive. The median follow-up duration was 1268 （953 - 1926） days after diagnosis or 986 （725 - 1742） days after auto-PBSCT, and the average live time was 1475.7 days. The 3 year disease - free survival （DFS） was （66.7 ± 8. 1 ） %. Among the other twenty patients who are being still for long-interval maintenance therapy, two patients were relapse （10. 0% ） including one died patient（5.0% ）. Conclusion It suggested that auto-PBSCT combined with long-interval maintenance therapy could be used as an important treatment for adult acute nonlymphoblastie leukemia owing to its low HSCT related death and long DFS.

关 键 词：外周血干细胞移植 生物疗法 药物疗法 白血病 非淋巴细胞 急性/治疗 

分 类 号：R733[医药卫生—肿瘤]