单倍体相合与同胞全相合外周血造血干细胞移植治疗成人高危及难治/复发急性髓系白血病的疗效对比  

Effects of Peripheral Blood Stem Cell Transplantation from Haploidentical Versus Matched Sibling Donors on High-risk and Refractory/Relapsed Acute Myeloid Leukemia

作　　者：苗文艳 蔺思颖 徐建丽[1] 王洪波[1] 江明[1] MIAO Wenyan;LIN Siying;XU Jianli;WANG Hongbo;JIANG Ming(Hematologic Disease Center,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang Uygur Autonomous Region Research Institute of Hematology,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院血液病中心,新疆维吾尔自治区血液病研究所,乌鲁木齐830054

出　　处：《肿瘤防治研究》2023年第10期988-993,共6页Cancer Research on Prevention and Treatment

基　　金：国家自然科学基金(81660032);新疆维吾尔自治区研究生科研创新项目(XJ2022G155)。

摘　　要：目的探讨单倍体相合与同胞全相合外周血造血干细胞移植治疗高危及难治/复发急性髓系白血病(AML)患者的临床疗效。方法回顾性分析2010年1月1日至2020年6月30日在我中心行清髓预处理单倍体相合外周血造血干细胞移植(Haplo-HSCT)治疗高危及难治/复发AML的疗效,并与同期行同胞全相合外周血造血干细胞移植(MSD-HSCT)的结果进行比较。结果共纳入98例患者,其中Haplo-HSCT组62例,MSD-HSCT组36例,两组患者中位年龄、预处理方案、MNC及CD34+细胞输注剂量差异具有统计学意义,其余基线指标差异均无统计学意义。Haplo-HSCT组与MSD-HSCT组急性及慢性移植物抗宿主病(GVHD)发生率比较差异均无统计学意义。移植后相关感染并发症两组相比差异均无统计学意义。Haplo-HSCT组的3年累积复发率显著低于MSD-HSCT组(16.2%vs.41.1%,P=0.036);Haplo-HSCT组、MSD-HSCT组3年DFS分别为66.98%和41.8%,两组差异无统计学意义(P=0.140);Haplo-HSCT组、MSD-HSCT组OS分别为73.37%和51.41%,两组差异无统计学意义(P=0.105)。结论采用Haplo-HSCT治疗高危及难治/复发AML患者的临床疗效与MSD-HSCT相似,并且Haplo-HSCT可能有更好的GVL效应。Objective To investigate the clinical efficacy of peripheral blood stem cell transplantation from haploidentical and matched sibling donors for treatment of high-risk and refractory/relapsed acute myeloid leukemia(AML).Methods Data on the efficacy of haploidentical peripheral blood stem cell transplantation(Haplo-HSCT)with myeloablative conditioning regimen were retrospectively analyzed and compared with that of matched sibling donors’peripheral blood stem cell transplantation(MSD-HSCT)for treatment of highrisk refractory/relapsed AML in our center from January 1st,2010 to June 30th,2020.Results A total of 98 patients were enrolled,including 62 patients in the Haplo-HSCT group and 36 patients in MSD-HSCT group.The median age,conditioning regimen,and infusion doses of MNC and CD34+cells were significantly different between the two groups,but no significant differences in other baseline parameters were found.Transplantation-related infectious complications and the incidence of acute and chronic graft-versus-host disease(GVHD)were also not significantly different between the two groups.The 3-year cumulative relapse in the Haplo-HSCT group was significantly lower than that in the MSD-HSCT group(16.2%vs.41.1%,P=0.036).The 3-year DFS of the Haplo-HSCT and MSD-HSCT groups were 66.98%and 41.8%,respectively(P=0.140),and their OS were 73.37%and 51.41%,respectively(P=0.105).Conclusion The clinical efficacy of Haplo-HSCT for the treatment of high-risk and refractory/relapsed AML is similar to that of MSD-HSCT,and Haplo-HSCT may have better GVL effect.

关 键 词：外周血造血干细胞移植 急性髓系白血病 高危 难治性 复发性 

分 类 号：R552[医药卫生—血液循环系统疾病]