骨髓增生异常综合征和再生障碍性贫血患者异基因造血干细胞移植的时机选择：第56届美国血液学会年会报道  

Timing of allogeneic stem cell transplantation for myelodysplastic syndromes and aplastic anemia：reports from the 56th American Society of Hematology annual meeting

作　　者：唐旭东[1,2] 张路[3] 刘锋[1] 

机构地区：[1]中国中医科学院西苑医院血液科,100091 [2]中国中医科学院博士后科研流动站 [3]北京中医药大学管理学院

出　　处：《白血病．淋巴瘤》2015年第3期132-134,共3页Journal of Leukemia & Lymphoma

基　　金：国家自然科学青年基金（81303127）;中国博士后科学基金（2014M551002）;国家中医药管理局行业科研专项（201107001）

摘　　要：介绍第56届美国血液学会（ASH）年会关于骨髓增生异常综合征（MDS）和再生障碍性贫血（AA）患者进行异基因造血干细胞移植的时机选择的报道.同种异体造血干细胞移植（HSCT）治疗MDS是疾病治愈的有效途径,但病死率也很高.对于低危和中危-Ⅰ MDS患者,应尽量延后HSCT的应用时间.但是对中危-Ⅱ和高危MDS患者,在确诊后应尽快进行HSCT,其生存期明显优于延后HSCT的患者.HSCT前的预处理方案可以选择阿扎胞苷、白血病形式的诱导化疗或联合以上2种治疗.HSCT已被证实可以治愈重型AA,但新诊断的患者中HLA相合的同胞供者仅占1/4.总之,HLA匹配的相关和无关供者HSCT会成为大多数高危MDS和初发重型AA的治疗选择.New progresses of timing of allogeneic hematopoietic stem cell transplantation （allo-HSCT） for myelodysplastic syndrome （MDS） and aplastic anemia in the 56th ASH annual meetings were reviewed.Allo-HSCT for MDS was a potentially curative procedure,but it was associated with a significant risk of morbidity and mortality.With the recent approval of disease-modifying agents,the appropriate timing of alloHSCT needed to be addressed.For low and intermediate-1 IPSS risk groups,the decision to delay HSCT from the time of diagnosis maximized overall survival.For patients with intermediate-2 and high-risk disease,immediate HSCT at the time of diagnosis was associated with a greater number of life-years than HSCT at a delayed time point.The methods that underwent HSCT were after azacitidine,leukemia-type induction chemotherapy,or both.for severe aplastic anemia （SAA）,HSCT was a proven cure,but HLA-matched sibling donors were found in fewer than 25 % of newly diagnosed patients.The use of early unrelated donor HSCT was an evolving concept that will became more accepted as improvements in HSCT outcomes continued.Moving forward,HLA-matched related and unrelated donor HSCT will likely become the treatment of choice for most patients with higher-risk MDS and newly diagnosed SAA.

关 键 词：骨髓增生异常综合征 再生障碍性贫血 异基因造血干细胞移植 美国血液学会年会 

分 类 号：R551.3[医药卫生—血液循环系统疾病] R556.5[医药卫生—内科学]