脐血移植治疗难治复发急性白血病的临床分析  

Clinical analysis of umbilical cord blood transplantation in the treatment of refractory and recurrent acute leukemia

作　　者：朱平[1] 禹环[1] 符丽梅[1] 廖欣[1] 熊暮珺 雷阿明 祝平安[1] 梁欣荃[1] Zhu Ping;Yu Huan;Fu Limei;Liao Xin;Xiong Mujun;Lei Aming;Zhu Pingan;Liang Xinquan(Department of Hematology,The First People’s Hospital of Chenzhou,Chenzhou 423000,Hunan Province,China)

机构地区：[1]湖南省郴州市第一人民医院血液内科,湖南郴州423000

出　　处：《首都医科大学学报》2021年第6期1041-1045,共5页Journal of Capital Medical University

基　　金：湖南省临床医疗技术创新引导项目(2020SK50310)。

摘　　要：目的分析脐血移植(umbilical cord blood transplantation,UCBT)治疗难治复发急性白血病(relapsed/refractory acute leukemia,R/R-AL)患者的临床疗效。方法回顾性分析2016年1月至2020年12月在湖南省郴州市第一人民医院接受UCBT的22例患者,其中难治复发急性髓系细胞白血病(relapsed/refractory acute myelocytic leukemia,R/R-AML)18例、难治复发急性淋巴细胞白血病(relapsed/refractory acute lymphocytic leukemia,R/R-ALL)4例。结果①+42 d粒系植入率为100%(22/22);+100 d巨核系植入率为90.5%(19/21)。②+100 dⅢ~Ⅳ度急性移植物抗宿主病(acute graft versus host disease,aGVHD)累积发生比例为36.4%(8/22);3年慢性移植物抗宿主病(chronic graft versus host disease,cGVHD)累积发生比例为21.1%(4/19);3年重度cGVHD的累积发生比例为10.5%(2/19)。③3年累积复发率为3.2%;3年总生存率(overall survival,OS)为71.4%;3年无病生存率(disease-free survival,DFS)为70.9%。结论UCBT治疗R/R-AL患者具有重度cGVHD率低、复发率低、OS和DFS高等特点。Objective To analyze the clinical effect of umbilical cord blood transplantation(UCBT)in the treatment of relapsed/refractory acute leukemia(R/R-AL).Methods A retrospective analysis was performed on 22 patients who received UCBT from January 2016 to December 2020 The First People’s Hospital of Chenzhou,including 18 patients with refractory recurrent relapsed/refractory acute myelocytic leukemia(R/R-AML),4 patients with acute refractory/relapse acute lymphocytic leukemia(R/R-ALL).Results In the study,the rate of+42 d neutrophils implantation was 100%(22/22),the rate of megakaryocyte implantation on+100 days was 90.5%(19/21).The cumulative incidence ofⅢ-Ⅳacute graft versus host disease(aGVHD)at+100 days was 36.4%(8/22),the cumulative incidence of chronic graft versus host disease(cGVHD)for 3 years was 21.1%(4/19),and the cumulative incidence of severe cGVHD at 3 years was 10.5%(2/19).The 3-year cumulative recurrence rate was 3.2%;the 3-year overall survival(OS)was 71.4%;the 3-year disease-free survival(DFS)was 70.9%.Conclusion R/R-AL patients treated with UCBT had low rate of severe cGVHD,low recurrence rate,and higher OS and DFS.

关 键 词：脐血移植 急性白血病 疗效分析 

分 类 号：R55[医药卫生—血液循环系统疾病]