自体骨髓移植治疗急性白血病疗效探讨(附35例报告)

Clinical study of autologous bone marrow transplantation in the treatment of 35 patients with acute leukemia

目的评价自体骨髓移植（ABMT）治疗急性白血病的疗效。方法自1999—10—2004—10，用ABMT治疗急性白血病（CR1期）35例，中位年龄32．5（9—55）岁。其中急性非淋巴细胞白血病（ANLL）26例，急性淋巴细胞白血病（ALL）9例。预处理方案为马法兰（Mel）140—180mg／m^2＋环磷酰胺（CTX）120mg／kg＋阿糖胞苷（Ara—C）3g／m^2。结果所有患者移植后均重建造血，中位随诊时间756（186～1905）d，ANLL、ALL移植者3年无病生存率分别为（65．4±8．9）％和（33．3±13．6）％，复发率（30．6±9．2）％和（60．7±25．5）％。结论为降低急性白血病复发率和提高无病生存率，无异基因造血干细胞移植条件的患者适合接受ABMT。

Objective To evaluate the clinical effects of autologous bone marrow transplantation （ABMT） in the treatment of patients with acute leukemia. Methods A retrospective study was accomplished on the ABMT in the treatment of 35 patients with acute leukemia from Oct 1999 to Oct 2004. The median age of the patients was 32. 5 （9 - 55 ） years. Of the 35 patients, 26 cases were acute non - lymphocytic leukemia （ANLL） and 9 cases were acute lymphoblastic leukemia （ALL）. The patients were pretreated with melphalan （140 - 180mg/m^2） , cyclophosphamide （120mg/kg） and arabinosylcytosin （3g/m^2）. Results All patients engrafted successfully. The median follow - up duration was 756 （ 186 - 1950） days. The 3 - year probabilities of disease - free - survival （DFS） for ANLL and ALL were （ 65, 4% ± 8.9） % and （ 33.3 ± 13.6） % respectively , and the probabilities of relapse were （ 30. 6 ± 9. 2 ） % and （ 60. 7 ± 25.5 ） %, respectively. Conclusion To decrease relapse and increase DFS, patients with acute leukemia who have no chance for allogene haemopoietic stem cell transplantation are recommended for ABMT.