异基因造血干细胞移植术治疗儿童白血病的效果观察及复发影响因素分析  

Effect of Allogeneic Hematopoietic Stem Cell Transplantation in the Treatment of Childhood Leukemia and Analysis of Influencing Factors of Recurrence

作　　者：叶璐[1] 杨德彬 李曼[1] YE Lu;YANG Debin;LI Man(Children's Hospital Affiliated to Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院,郑州儿童医院,450000

出　　处：《实用癌症杂志》2023年第1期59-61,69,共4页The Practical Journal of Cancer

摘　　要：目的 分析异基因造血干细胞移植术(allo-HSCT)治疗儿童白血病的效果,并探讨其复发影响因素。方法回顾性选取82例白血病患儿,均行allo-HSCT治疗,并观察allo-HSCT治疗效果。于移植后随访2年,统计复发情况,同时收集患儿一般资料,采用单因素和多因素Logistic回归分析allo-HSCT后复发的相关影响因素。结果 82例经allo-HSCT治疗白血病患儿均全部植入成功,完全缓解(CR)、部分缓解(PR)分别为80例、2例;移植后随访2年,有16例复发,占比19.51%。复发组与未复发组患者年龄、性别、供者来源、移植物来源、疾病类型、供者人类白细胞抗原(HLA)相合程度、巨细胞病毒感染、急性移植物抗宿主病(GVHD)比较,差异无统计学意义(P>0.05);复发组诱导疗程数多、无慢性GVHD、移植前伴髓外病变占比高于未复发组,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,诱导疗程数多、无慢性GVHD、移植前伴髓外病变均是allo-HSCT后复发的独立危险因素。结论 诱导疗程数多、无慢性GVHD、移植前伴髓外病变均是allo-HSCT后复发的独立危险因素,临床应给予高度重视。Objective To analyze the effect of allogeneic hematopoietic stem cell transplantation(allo HSCT) in the treatment of childhood leukemia and to explore the influencing factors of recurrence.Methods 82 children with leukemia were analyzed retrospectively.All of them were treated with allo HSCT,and the therapeutic effect of allo HSCT was observed.The patients were followed up for 2 years after transplantation, the recurrence was counted, and the general data of children were collected.The related factors of recurrence after allo HSCT were analyzed by univariate and multivariate logistic regression.Results 82 children with leukemia treated by allo HSCT were implanted successfully.The complete remission(CR) and partial remission(PR) were 80 and 2 respectively;Followed up for 2 years after transplantation, 16 cases recurred, accounting for 19.51%;There was no significant difference in age, sex, donor source, graft source, disease type, donor human leukocyte antigen(HLA) consistency, cytomegalovirus infection and acute graft-versus-host disease(GVHD) between the two groups(P>0.05);The recurrence group had more induction courses, no chronic GVHD,and the rate of extramedullary lesions before transplantation was higher than that in the non recurrence group(P<0.05);Multivariate logistic regression analysis showed that the number of induction courses, no chronic GVHD and the rate of extramedullary lesions before transplantation were independent risk factors for recurrence after allo HSCT.Conclusion The number of induction courses, no chronic GVHD and the rate of extramedullary lesions before transplantation are independent risk factors for recurrence after allo HSCT,which should be paid great attention in clinic.

关 键 词：儿童白血病 异基因造血干细胞移植术 复发 影响因素 

分 类 号：R733.7[医药卫生—肿瘤]