含去甲氧柔红霉素的预处理方案在异基因造血干细胞移植治疗高危难治性白血病中的疗效分析  

Analysis of the efficacy of pretreatment regimen containing idarubicin in allogeneic hematopoietic stem cell transplantation for highrisk refractory leukemia

作　　者：程昊钰[1] 杨怡欣 杨帆[1] 张维婕[1] 费新红[1] 殷宇明[1] 顾江英[1] 满其航[1] 赵杰[1] 王静波[1] Cheng Haoyu;Yang Yixin;Yang Fan;Zhang Weijie;Fei Xinhong;Yin Yuming;Gu Jiangying;Man Qihang;Zhao Jie;Wang Jingbo(Department of Hematology,Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院血液科,北京100049

出　　处：《器官移植》2020年第2期240-246,共7页Organ Transplantation

摘　　要：目的探讨含去甲氧柔红霉素(IDA)的预处理方案在异基因造血干细胞移植(allo-HSCT)治疗高危难治性白血病中的临床疗效。方法对116例接受了allo-HSCT的高危难治性白血病患者,采用7种含IDA的预处理方案。总结116例受者的植入情况。采用Kaplan-Meier曲线对2年总生存率(OS)、2年无病生存率(DFS)、累积复发率、复发病死率、移植相关病死率(TRM)、急性移植物抗宿主疾病(aGVHD)及慢性移植物抗宿主疾病(cGVHD)的累积发生率进行统计学分析。结果116例受者均成功植入。中位随访时间为28(7~70)个月,64例受者存活,2年OS为55.2%,2年DFS为51.7%,2年复发病死率23.3%,2年TRM为18.1%。116例受者中有72例发生aGVHD,aGVHD 2年累积发生率为62.1%,其中Ⅲ~Ⅳ度aGVHD 20例,2年累积发生率为17.2%。59例发生cGVHD,2年累积发生率为55.4%,其中广泛型cGVHD 2年累积发生率为14.7%。116例受者中有30例复发,2年累积复发率为25.9%。结论含IDA的预处理方案安全性和有效性均较高,可以作为高危难治性白血病患者移植预处理的有效方案。Objective To investigate the clinical efficacy of pretreatment regimen containing idarubicin(IDA)in allogeneic hematopoietic stem cell transplantation(allo-HSCT)for high-risk refractory leukemia.Methods A total of 116 patients with high-risk refractory leukemia who received allo-HSCT treated with 7 types of IDA-containing pretreatment regimes were enrolled in this study.The implantation rate of 116 recipients was summed up.The 2-year overall survival(OS),2-year disease free survival(DFS),cumulative recurrence rate,recurrent mortality,transplantation related mortality(TRM),cumulative incidence of acute graft-versus-host disease(aGVHD)and chronic graft-versus-host disease(cGVHD)were statistically analyzed by Kaplan-Meier survival curve.Results All 116 recipients successfully implanted.The median follow-up time was 28(7-70)months.Among them,64 recipients survived,the 2-year OS was 55.2%,2-year DFS was 51.7%,2-year recurrent mortality was 23.3%and 2-year TRM was 18.1%.Among 116 recipients,72 cases suffered from aGVHD.The 2-year cumulative incidence rate of aGVHD was 62.1%including 20 cases of gradeⅢ-ⅣaGVHD,the 2-year cumulative incidence rate was 17.2%.Among 116 recipients,59 cases presented with cGVHD.The 2-year cumulative incidence rate was 55.4%,of which the 2-year cumulative incidence rate of extensive cGVHD was 14.7%.Among 116 recipients,30 cases recurred with a 2-year cumulative recurrence rate of 25.9%.Conclusions IDA-containing pretreatment regime has high safety and effectiveness,and can be used as an effective pretreatment regime for transplantation preprocessing in patients with high-risk refractory leukemia.

关 键 词：去甲氧柔红霉素 高危难治性白血病 急性髓系白血病 急性淋巴细胞白血病 预处理 异基因造血干细胞移植 复发 总生存率 无病生存率 累积复发率 

分 类 号：R617[医药卫生—外科学] R733.7[医药卫生—临床医学]