自体造血干细胞移植治疗老年恶性血液病的疗效和安全性  

Efficacy and safety of autologous hematopoietic stem cell transplantation in the treatment of elderly patients with hematological malignancies

作　　者：朱元玲 马洁娴 谢彦晖 Zhu Yuanling;Ma Jiexian;Xie Yanhui(Department of Hematology,Huadong Hospital Affiliated to Fudan University,Shanghai,200040,P.R.China)

机构地区：[1]复旦大学附属华东医院血液科,上海200040

出　　处：《老年医学与保健》2023年第3期453-456,463,共5页Geriatrics & Health Care

基　　金：上海市科学技术发展基金(21Y11909000)。

摘　　要：目的自体造血干细胞移植是血液系统肿瘤的有效治疗选择,但在老年患者中的应用仍有争议,本文旨在分析自体造血干细胞移植在老年患者中的疗效和安全性。方法回顾性分析2016年1月—2022年12月在华东医院血液科接受自体造血干细胞移植的患者数据,根据患者年龄分为老年组(≥60岁,n=25)和中青年组(<60岁,n=174),比较2组的外周造血干细胞动员效果、造血重建效果、肿瘤复发率、不良反应发生率和长期预后。结果与中青年组比较,老年组的造血干细胞动员效果和重建速率差异均无统计学意义(P>0.05),且不加重移植相关的不良反应。长期预后分析显示2组均未达到中位总生存期和中位无进展生存期,2组5年生存率和5年无进展生存率无差异,多因素分析表明年龄不是影响自体造血干细胞移植预后的独立危险因素。结论自体造血干细胞移植对于体能良好的老年恶性血液病患者是安全有效的治疗选择。Objective Autologous hematopoietic stem cell transplantation is an effective treatment option for hematologic tumors,but its use in elderly patients remains controversial.This paper aims to analyze the efficacy and safety of autologous hematopoietic stem cell transplantation in elderly patients.Methods The data of patients receiving autologous hematopoietic stem cell transplantation in Department of Hematology,Huadong Hospital Affiliated to Fudan University from January 2016 to December 2022 were retrospectively analyzed.They were divided into elderly group(≥60 years old,n=25)and young-middle-aged group(<60 years old,n=174)according to the age of the patients.The mobilization effect of peripheral stem cell,time of hematopoietic reconstruction,tumor recurrence rate,incidence of adverse reactions and long-term prognosis were compared between the two groups.Results There were no significant differences in the mobilization effect and reconstruction rate of hematopoietic stem cells between the elderly group and the young-middle-aged group(P>0.05).No adverse reactions related to transplantation were aggravated in the elderly group.Long term prognosis analysis showed that both groups did not achieve median overall survival and median progression-free survival,and there was no difference in 5-year survival and 5-year progression-free survival between the two groups.Multivariate analysis showed that age was not an independent risk factor for the prognosis of autologous hematopoietic stem cell transplantation.Conclusion Autologous hematopoietic stem cell transplantation is a safe and effective treatment option for elderly patients with hematologic malignancies who have good physical fitness.

关 键 词：老年 淋巴瘤 骨髓瘤 自体造血干细胞移植 

分 类 号：R733[医药卫生—肿瘤]