自体外周造血干细胞移植治疗13例AML1/ETO(+)急性髓系白血病的疗效观察  

Effect of Autologous Peripheral Blood Stem Cell Transplantation in 13 Patients with AML1/ETO(+) Acute Myeloid Leukemia

作　　者：张青宜[1] 黄文荣[1] 窦丽萍[1] 邓爱玲[1] 付林[1] 徐绎涵[1] 刘占祥[1] 李永辉[1] 王楠[1] 于力[1] 

机构地区：[1]中国人民解放军总医院血液科,北京100853

出　　处：《中国实验血液学杂志》2014年第2期447-452,共6页Journal of Experimental Hematology

基　　金：国家自然科学基金(81270611;81170518;81370635)

摘　　要：本研究分析自体外周造血干细胞移植治疗AML1/ETO(+)急性髓系白血病(AML)的疗效及定量监测融合基因AML1/ETO在治疗中的应用。对2007年8月-2012年11月在本院进行自体移植的AML1/ETO(+)AML患者13例进行回顾性分析,中位随访26(7.8-75.8)个月,计算总生存率(OS)、无白血病生存率(leukemiafree survival,LFS)和累积复发率(relapse rate,RR),并对生存情况进行单因素分析。结果表明,3年的总体存活率为(70.5±15.3)%,3年的无白血病存活率为(51.3±16.7)%,3年的累积复发率为48.7%。在5例复发患者中对4例进行了AML1/ETO定量监测,发现形态学复发前AML1/ETO表达量均明显升高。在单因素分析中,患者年龄、性别、初诊时白细胞数量、自确诊白血病到进行移植的时间间隔、回输MNC数量等对总体存活率的影响均差异无统计学意义(均P>0.05)。结论:自体造血干细胞移植对AML1/ETO(+)AML患者具有良好疗效,定期定量监测AML1/ETO表达量可预知早期复发,中高危患者复发后采用异基因移植可再次获得长期生存机会。This study was purposed to analyse the clinical effeicacy of autologous peripheral blood stem cell transplantation （APBSCT） in 13 Patients with AML1/ETO （ ＋ ） acute myeloid leukemia, and to evaluate the role of quantitative detecting the AML1/ETO gene in treatment of AML patients. A total of 13 patients with AML1/ETO （ ＋ ） acute myeloid leukemia treated with APBSCT from August 2007 to November 2012 were retrospectively analyzed. The median follow-up time was 26 （7.8 - 75.8 ） months. Kaplan-Meier analysis was used to calculate the overall survival （OS）, leukemia-free survival（LFS） and cumulative relapse rate（RR）. Log rank method was used to perfom univariate analysis. The results showed that the 3 year-OS, LFS, and RR were （70.5± 15.3）%, （51.3± 16.7）%, 48.7%, respectively. The AML1/ETO expression level in 4 cases out of 5 relapsed patients was quantified during and after therapy, and the result showed that AML1/ETO expression level significantly increased before morphological relapse. In univariate analysis, there was no statistic significance in terms of age, sex, count of white blood cells at diagnosis, interval from diagnosis to transplantation, count of MNC for infusion. It is concluded that APBSCT has good therapeatic effect on AML1/ETO （ ＋ ） AML, and regular quantitative monitoring of AML1/ETO expression level can predict early recurrence. Allogeneic hematopoietic stem cell transplantation after relapse may contribute to obtain opportunity to achieve the long-term survival for intermediate and high risk patients.

关 键 词：外周血造血干细胞移植 AML1 ETO基因 急性髓系白血病 

分 类 号：R457.7[医药卫生—治疗学] R733.71[医药卫生—临床医学]