自体骨髓移植治疗急性白血病73例疗效分析  

Outcome of autologous bone marrow transplantation in 73 patients with acute leukemia

作　　者：韩明哲[1] 冯四洲[1] 李成文[1] 邱录贵[1] 姜容[1] 井丽萍[1] 姜尔烈[1] 张莉[1] 万长春[1] 严文伟[1] 

机构地区：[1]中国医学科学院中国协和医科大学血液学研究所血液病医院

出　　处：《中华血液学杂志》1998年第8期422-424,共3页Chinese Journal of Hematology

基　　金：卫生部科学研究基金

摘　　要：目的：评价自体骨髓移植（ＡＢＭＴ）治疗急性白血病的疗效。方法：自１９８６年１０月至１９９７年１２月，用ＡＢＭＴ治疗急性白血病７３例，中位年龄２５．５（９～４８）岁。其中急性非淋巴细胞白血病（ＡＮＬＬ）４３例（ＣＲ１３５例，ＣＲ２或早期复发８例），急性淋巴细胞白血病（ＡＬＬ）３０例（ＣＲ１２５例，ＣＲ２或早期复发５例）。预处理方案包括环磷酰胺（ＣＴＸ）１２０ｍｇ／ｋｇ＋单次全身照射（ＳＴＢＩ）９～１０Ｇｙ或马利兰（Ｂｕ）１６ｍｇ／ｋｇ或马法兰（Ｍｅｌ）１６０～１８０ｍｇ／ｍ２＋阿糖胞苷（ＡｒａＣ）４ｇ／ｍ２。结果：所有患者移植后均重建造血，中位随访时间８０６（３２～３４００）天，移植相关死亡７例（９．５％），ＡＮＬＬ、ＡＬＬＣＲ１期移植者３年无病生存率分别为５４９％±７．７％和６７．０％±１０６％，复发率３９．３％±９．３％和２３．７％±１０．６％。结论：为降低白血病复发率和提高患者无病生存率，无骨髓供者的ＣＲ１期急性白血病患者适合接受ＡＢＭＴ。Objective: To evaluate the clinical outcome of autologous bone marrow transplantation(ABMT) in acute leukemias. Methods: Data of 73 acute leukemia patients performed ABMT in our hospital from October 1986 to December 1997 were retrospectively analyzed. The median age was 25.5(9～48) years. Fortythree of them were ANLL [CR1 35,CR2 or early relapse (ER)8],30 were ALL (CR1 25,CR2 or ER 5). Conditioning regimens were CTX 120mg/kg+STBI 9～10Gy or Bu 16mg/kg or Mel 160～180mg/m2+AraC 4g/m2. Results: All patients engrafted successfully. The median followup duration was 806 (32～3400) days. The 3year probabilities of diseasefree survival (DFS) for ANLL and ALL in CR1 were 54.9%±7.7% and 67.0%±106%, respectively,and the probabilities of relapse were 39.3%±9.3% and 23.7%±10.6%,respectively. Conclusion: To decrease relapse and increase DFS, patients with acute leukemia in CR1 who have no HLAmatched related donor are recommended for ABMT.

关 键 词：白血病 急性 骨髓移植 自体移植 

分 类 号：R733.710.5[医药卫生—肿瘤] R457.7[医药卫生—临床医学]