异基因造血干细胞移植治疗Ph+急性淋巴细胞白血病的疗效观察  

Efficiency of allogeneic hematopoietic stem cell transplantation for treatment of philadelphia chromosome positive acute lymphoblastic leukemia

作　　者：张燕[1] 赵鹏[1] 熊杰[1] 卢英豪[1] 李梦醒[1] 王季石[1] 

机构地区：[1]贵州医科大学附属医院血液科,贵阳550004

出　　处：《江西医药》2016年第3期207-208,211,共3页Jiangxi Medical Journal

摘　　要：目的探讨异基因造血干细胞移植(allo-HSCT)治疗Ph+急性淋巴细胞白血病(Ph+ALL)的疗效。方法对我院2010年5月-2015年8月收治的Ph+ALL患者21所进行的allo-HSCT治疗效果进行小结,所有病人均联合伊马替尼治疗。人类白细胞抗原(human leukocyte antige,HLA)相合同胞供者12例,HLA不全相合的亲缘供者9例,采用改良BU/CY方案预处理,随访至2015年10月31日。平均随访时间25个月(2-65个月)。结果所有患者均成功植入,allo-HSCT后2年累积总体生存率(OS)为54.3%,无病生存率(DFS)为41.3%,复发率(RR)为29%。移植前处于CR1患者2年OS为57.6%,DFS为40.5%,显著高于非CR1患者(P<0.05),而RR分别为25.2%和30.1%,差异无统计学意义。疾病状态和BCR/ABL融合基因蛋白类型均影响患者的OS和RR。结论 ph+ALL患者行allo-HSCT后仍易复发,采用依托泊苷(etoposide,VP16)强化的BU/CY预处理方案显示疗效较好,但仍需更多的病例观察。Objective To explore the efficiency of allogeneic hematopoietic stem cell transplantation（allo-HSCT） for treatment of philadelphia chromosome positive acute lymphoblastic leukemia（Ph＋ALL） patients. Methods From 2010 to 2015 21 patients with Ph ＋ALL were treated with allo-HSCT,All patients were treated combined with Imatinib. 12 from human leukocyte antige（HLA）-matched sibling donors,9 from haploidentical donor. All patients with conditioning regiment of BU/CY. The follow-up ended at Oct 31 2015. The average follow-up was 25 months（2-65months）. Results All patients achieved stable engraftment,The 2-year overall survival（os） and disease-free survival（DFS） was 54.3% and 41.3%,The relapse rate（RR）was 29%. The 2-year OS and DFS were significantly longer for patients in CR1 than non CR1,RR was no significantly between them. The status of disease pre-HSCT and BCR/ABL subtype was the risk factor of OS or RR. Conclusion There was more relapse in patients with ph＋ALL after allo-HSCT. Better outcome of ph＋ALL after allo-HSCT with etoposide-intensified conditioning regimens,But still need more cases observation.

关 键 词：白血病 淋巴细胞 急性 造血干细胞移植 

分 类 号：R733.71[医药卫生—肿瘤]