异基因造血干细胞移植治疗急性髓系白血病的临床分析  

Clinical Analysis of Allogeneic Hematopoietic Stem Cell Transplantation in the Treatment of Acute Myeloid Leukemia

作　　者：吴奕飞 李祎 赵航[1] 刘艳杰[1] WU Yifei;LI Yi;ZHAO Hang(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000)

机构地区：[1]郑州大学第一附属医院,450000

出　　处：《实用癌症杂志》2023年第8期1276-1279,共4页The Practical Journal of Cancer

摘　　要：目的 探讨异基因造血干细胞移植(allo-HSCT)对急性髓系白血病(AML)的治疗效果,分析可能影响预后的相关因素。方法 回顾性分析47例AML患者的临床资料,所有患者均行allo-HSCT治疗。应用Kaplan-Meier生存曲线评定患者的总生存率(OS),采用Log-rank检验行不同组别的比较,应用Cox回归法探究影响预后的有关因素。结果47例患者中存活32例,死亡15例,7例复发;5年OS为(61.23±6.75)%,中位生存时间77.6个月,5年复发率为(15.83±4.26)%;Log-rank检验结果表明前后期各不相同的移植方案、缓解次数、移植前缓解情况、各不相同的供者来源、是否合并移植物宿主病(GVHD)与OS无关(P>0.05);多因素分析表明,合并髓系肉瘤和复发为患者预后的主要影响因素(P<0.05)。结论 allo-HSCT在AML患者治疗中效果确切,随着移植手段的转变与支持治疗的进步,患者的生存周期逐渐延长,而合并髓系肉瘤和复发是造成不良预后的有关因素,临床需予以积极的重视。Objective To investigate the therapeutic effect of allogeneic hematopoietic stem cell transplantation(allo HSCT) in acute myeloid leukemia(AML) and explore the related factors that may affect the prognosis.Methods Clinical data of 47 patients with AML were analyzed retrospectively.All patients were treated with allo HSCT.Kaplan Meier survival curve was used to evaluate the overall survival rate(OS),log rank test was used to compare different groups,and Cox regression was used to explore the relevant factors affecting the prognosis.Results Among the 47 patients,32 survived,15 died and 7 relapsed;The 5-year OS was(61.23±6.75)%,the median survival time was(77.6) months,and the 5-year recurrence rate was(15.83±4.26)%;The results of log rank test showed that the different transplantation schemes,remission times,remission before transplantation,different donor sources,whether combined with graft host disease(GVHD) had no effect on OS(P>0.05);Multivariate analysis showed that myeloid sarcoma and recurrence were the main prognostic factors(P<0.05).Conclusion Allo HSCT is effective in the treatment of AML patients.With the transformation of transplantation methods and the progress of supportive treatment,the survival cycle of patients is gradually prolonged.Myeloid sarcoma and recurrence are the relevant factors causing poor prognosis,which should be actively paid attention to in clinic.

关 键 词：急性髓系白血病 异基因造血干细胞移植 生存率 预后 

分 类 号：R733.71[医药卫生—肿瘤]