移植前使用α干扰素对慢性粒细胞白血病患者非亲缘异基因骨髓移植预后的影响

The effect of pretransplant interferon-αtherapy on the outcome of unrelated donor bone marrow transplantation for patients with chronic myelogenous leukemia

目的了解α干扰素(IFN-α)在移植前使用对慢性粒细胞白血病(CML)患者非亲缘异基因骨髓移植(URD-BMT)预后的影响。方法分析总结行URD-BMT的CML第1次慢性期(CP1)患者53例,其中BMT前未用IFN-α治疗组23例,用IFN-α治疗组30例;其中疗程≤12个月22例,>12个月8例。采用单因素分析和Cox比例风险模型分析移植前使用IFN-α对CML患者URD-BMT后植入效果、急性移植物抗宿主病(GVHD)发生及患者5年存活率的影响。结果经Cox模型多元回归分析,患者年龄、性别、确诊至URD-BMT的时间、停IFN-α距URD-BMT时间对生存率无影响;各组的总生存率、无病生存率、非复发死亡率、植活率、复发率、植入失败率、急性GVHD和慢性GVHD发生率差异均无统计学意义均(P>0.05)。结论本文资料所列条件下,移植前使用IFN-α不会对URD-BMT产生不利影响。

Objective To investigate whether pretransplant interferon-α （IFN-α） therapy affects the out- come of unrelated donor bone marrow transplantation （URD-BMT） in patients with chronic myelogenous leukemia （CML）. Methods The outcome of 53 patients with CML in first chronic phase received URD-BMT were analyzed with Cox model of muhivariable regression. Of the 53 patients, 23 patients did not receive lFN-αbefore transplant, 22 patients received IFN-α3×10^6 units 3-4 times per week for 12 months or less, and 8 patients for more than 12 months. Results No effect of lFN-αadministration was associated with overall survival, leukemia-free survival, non-relapse mortality, relapse, and acute or chronic graft-versus-host disease. Conclusion No evidence was found for adverse effect of lFN-αpretreatment on the outcome of subsequent URD-BMT.