治疗相关性白血病异基因造血干细胞移植疗效分析  

Efficacy analysis of allogeneic hematopoietic stem cell transplantation on therapy⁃related leukemia

作　　者：张书芹[1] 费新红[1] 温红霞 刘圆圆 程昊钰[1] 张维婕[1] 王静波[1] Zhang Shuqin;Fei Xinhong;Wen Hongxia;Liu Yuanyuan;Cheng Haoyu;Zhang Weijie;Wang Jingbo(Department of Hematology,Aerospace Central Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院血液科,北京100049

出　　处：《白血病．淋巴瘤》2021年第5期277-281,共5页Journal of Leukemia & Lymphoma

摘　　要：目的探讨异基因造血干细胞移植(allo⁃HSCT)对治疗相关性白血病(TRL)的临床效果。方法回顾性分析2012年4月至2020年2月于航天中心医院接受allo⁃HSCT的14例TRL患者的临床资料,分析其疗效及生存情况。结果14例患者中,男性5例,女性9例;中位年龄35岁(12~59岁);急性髓系白血病12例,慢性淋巴细胞白血病/小细胞淋巴瘤1例,急性淋巴细胞白血病1例。移植时4例骨髓完全缓解,3例骨髓部分缓解,其余7例均未缓解。亲缘全相合移植5例,单倍型移植9例,均采用清髓性预处理方案。14例患者均顺利植活,中位粒细胞植活时间为16 d(10~24 d),中位血小板植活时间为13 d(10~34 d)。7例发生Ⅰ~Ⅱ级急性移植物抗宿主病(GVHD),6例发生慢性GVHD,2例发生Ⅲ级肠道GVHD。中位随访时间32个月(4~97个月),14例患者中5例死亡。结论allo⁃HSCT可以改善TRL患者的预后,提高长期生存率。Objective To investigate the clinical efficacy of allogeneic hematopoietic stem cell transplantation(allo⁃HSCT)on therapy⁃related leukemia(TRL).Methods The clinical data of 14 patients with TRL who received allo⁃HSCT in Aerospace Central Hospital from April 2012 to February 2020 were retrospectively analyzed,and the therapeutic efficacy and survival status were also analyzed.Results Of the 14 patients,5 were males and 9 were females;the median age was 35 years old(12-59 years old).There were 12 patients with acute myeloid leukemia,1 patient with chronic lymphocytic leukemia/small cell lymphoma,and 1 patient with acute lymphoblastic leukemia.At the time of transplantation,4 patients achieved bone marrow complete remission,3 patients achieved bone marrow partial remission,and the remaining 7 patients had no remission.Five patients received HLA⁃matched sibling transplantation,9 patients received haplotype transplantation,and they all received myeloablative pretreatment schemes.All 14 patients were successfully implanted;the median engraftment time of granulocyte was 16 d(10-24 d),and the median engraftment time of platelet was 13 d(10-34 d).GradeⅠ-Ⅱacute graft⁃versus⁃host disease(GVHD)occurred in 7 patients,chronic GVHD occurred in 6 patients,and gradeⅢintestinal GVHD occurred in 2 patients.The median follow⁃up time was 32 months(4-97 months).Among 14 patients,5 patients died.Conclusion The allo⁃HSCT can improve the prognosis and long⁃term survival rate of TRL patients.

关 键 词：白血病 肿瘤 继发原发性 造血干细胞移植 治疗结果 

分 类 号：R733.7[医药卫生—肿瘤]