无染色体异常的急性白血病自体造血干细胞移植的疗效

Evaluation of Auto-Peripheral Blood Stem Cells Transplantation for Acute Leukemia Without Abnormal Chromosome

目的评价自体外周血造血干细胞移植(PBSCT)治疗无染色体异常的急性白血病(AL)的疗效。方法12例急性淋巴细胞性白血病(ALL)和10例急性髓细胞性白血病(AML)病人,在诱导治疗获得第一次缓解后(CR1)分为自体PBSCT组和继续常规化疗组对照研究。结果自体移植组中5例CR1的AML,2年以上无病生存率(DFS)为80%;6例CR1的ALL,2年以上DFS为60%,而且自体移植后存活的病人均无生活质量问题。采用常规化疗的病人,5例CR1的AML,2年以上DFS仅为40%;6例CR1的ALL,2年以上DFS为40%,提示自体移植疗效好于常规化疗。结论对于无染色体异常核型的中危和低危急性白血病病人,若无HLA相合供体,应首选自体PBSCT作为巩固治疗。

Objective To evaluate the effect of auto-peripheral blood stem cells transplantation (PBSCT) for acute leukemia (AL) without abnormal chromosome. Methods Twenty-two middle-aged and young AL patients were divided into 2 groups: auto-PBSCT and routine chemotherapy group. The auto-PBSCT group had acute lymphocytic leukemia (ALL) 6 cases and acute myeloid leukemia (AML) 5 cases, and were treated by auto-PBSCT for 4~10 months after complete remission (CR). The routine chemotherapy group also had ALL 6 cases and AML 5 cases, with clinical features and age similar to the auto-PBSCT group, and continued routine chemotherapy after CR. Results The 2 year survival (DFS) was 80% in ALL and 60% in AML for the auto-PBSCT group, and the quality of life (QOL) was normal after PBSCT. But the 2 year survival was only 40% in ALL and AML for the routine chemotherapy group. The results showed that the effect of auto-PBSCT was better than routine chemotherapy. Conclusion The first choice will be auto-PBSCT for the ALL or AML patients without abnormal chromosome while they could not find the HLA compatibility donor.