EBMT积分体系在异基因造血干细胞移植治疗恶性血液疾病中的预后价值  

Prognostic significance of EBMT score system for hematological malignancies with allogeneic hematopoietic stem cell transplantation

作　　者：王苓[1] 唐暐[1] 樊星[1] 赵维莅[1] 陈玉宝[1] 沈志祥[1] 李军民[1] 胡炯[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院血液科骨髓移植病区,200025

出　　处：《中华血液学杂志》2013年第8期655-658,共4页Chinese Journal of Hematology

摘　　要：目的分析恶性血液疾病异基因造血干细胞移植（allo-HSCT）治疗的危险因素，探索中国人群EBMT积分预测移植长期疗效的临床意义。方法回顾性分析144例allo-HSCT治疗的血液病患者，预后评估参照EBMT积分，危险因素包括患者年龄、疾病状态、诊断至移植时间、供／患者性别组合、供体来源。将患者分为3组：低危组（O～1分）、中危组（2～3分）和高危组（4～7分）。结果移植后所有患者的中位随访时间为413（10～1827）d，存活患者中位随访837（166～1827）d，预期4年总生存（OS）率、移植相关死亡率（TRM）及复发率（RR）分别为（57．5±4．6）％、（21．6±3．7）％和（42．7±6．1）％。其中低危组4年OS率、TRM、RR分别为（72．2±9．0）％、（8．1±4．5）％和（27．3±8．7）％，明显优于中危组[分别为（57．7±6．0）％、（23．1±5．1）％和（44．9±8．3）％]和高危组[分别为（36．9士10．2）％、（33．5±9．2）％、（51．5±11．8）％]，差异具有统计学意义（P值分别为〈0．01、0．02和0．009）。结论EBMT积分体系能有效提示allo-HSCT治疗恶性血液病的OS率、TRM和RR。Objective To evaluate the impact of EBMT score system in patients with hematologi- cal malignancies received allogeneic hematopoietic stem cell transplantation （allo-HSCT）. Methods A total of 144 consecutive patients were analyzed retrospectively. According to the EBMT score system, including age, disease status before transplantation, interval between diagnoses to transplantation, donor/recipient sex match and donor type, patients were divided into 3 risk groups： low risk （score 0-1）, intermediate risk （score 2-3） and high risk （score 4-7）. Results The median follow-up duration were 413 （10-1827） days for all patients and 837 （166-1827） days for alive patients. The estimated 4-year overall survival （OS）, transplant-related mortality （TRM） and relapse rate （RR） were （57.5±4.6）%, （21.6±3.7）% and （42.7±6.1）%, respectively. The 4-year OS, TRM and RR were （72.2±9.0）%, （8.1 ±4.5）% and （27.3±8.7）% in the low-risk group, significantly superior to both intermediate-risk group I （57.7±6.0）%, （23.1±5.1）% and （44.9±8.3）% ] and high-risk group [（36.9±10.2）%, （33.5±9.2）% and （51.5±11.8）%] （P〈0.01,0.02 and 0.009 for OS, TRM and RR respectively）. Conclusion The EBMT score system provides prognostic significance for OS, TRM and RR in patients with hematological malignancies received allo-HSCT.

关 键 词：EBMT积分 造血干细胞移植 血液肿瘤 预后 

分 类 号：R55[医药卫生—血液循环系统疾病]