二次移植治疗异基因造血干细胞移植后复发儿童急性白血病的临床疗效分析  

Clinical efficacy of secondary transplantation in the treatment of leukemia recurrence after allogeneic hematopoietic stem cell transplantation in children

作　　者：井远方 王彬[1] 秦茂权[1] 杨骏[1] 朱光华[1] 王凯[1] JING Yuanfang;WANG Bin;QIN Maoquan;YANG Jun;ZHU Guanghua;WANG Kai(Hematology Center,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China)

机构地区：[1]首都医科大学附属北京儿童医院,北京100045

出　　处：《中国小儿血液与肿瘤杂志》2023年第3期165-169,共5页Journal of China Pediatric Blood and Cancer

摘　　要：目的探讨二次单倍体移植治疗异基因造血干细胞移植后复发的儿童急性白血病的效果。方法回顾性分析本中心2014年3月1日—2022年5月30日儿童急性白血病异基因造血干细胞移植术后复发后接受二次单倍体异基因造血干细胞移植的7例病例资料,其中急性髓细胞白血病5例,急性淋巴细胞白血病2例,分析二次移植后总体生存率、无病生存率、移植相关死亡率。结果7例患儿均完成造血重建,粒细胞植入中位时间11(9-17)天,血小板植入中位时间13(9-18)天,随访至2022年5月30日,1例因原发病未缓解死亡,1例于移植+86天原发病复发,且合并休克、呼吸衰竭,家属放弃治疗死亡。2例合并慢性移植物抗宿主病(cGVHD),为皮肤局限型。1年总生存率(OS)71%(5/7),1年无病生存率(DFS)43%(3/7)。结论二次单倍体异基因造血干细胞移植治疗儿童白血病疗效较好,是异基因造血干细胞移植后复发的儿童白血病患儿的治疗方法之一。Objective To study the efficacy of the secondary haploid allogeneic hematopoietic stem cell transplantation in the treatment of leukemia recurrence after allogeneic hematopoietic stem cell transplantation in children.Methods The clinical date of 7 patients with acute leukemia who received the secondary transplantation from March 2014 through March 2022 due to the recurrence after allogeneic hematopoietic stem cell transplantation in children with acute leukemia were analyzed.Two patients were acute lymphoblastic leukemia,five were acute non-lymphoblastic leukemia;Overall survival,disease-free survival(DFS),transplant related mortality(TRM)were summarized.Results All of the 7 children obtained completed hematopoietic reconstruction.The median time to neutrophil and platelet engraftment was 11 days and 13 days respectively.The follow-up so far showed that,1 case died of primary disease,1 case relapsed at+86 days after transplantation,and died of shock and respiratory failure,5 cases currently survived,of which 2 cases were complicated with cGVHD,which was skin localized type,1-year overall survival rate was 71%(5/7),and 1-year disease-free survival rate was 43%(3/7).Conclusions Secondary haploid allogeneic hematopoietic stem cell transplantation has a good effect on the treatment of childhood leukemia,and is one of the treatment for children with leukemia who relapse after allogeneic hematopoietic stem cell transplantation.

关 键 词：二次异基因造血干细胞移植 儿童急性白血病 单倍体移植 

分 类 号：R733.71[医药卫生—肿瘤]