大剂量化疗、自体外周血干细胞移植、生物治疗、长间歇维持化疗序贯治疗急性白血病的临床观察

Clinical analysis of acute leukemia treated by high-dose chemotherapy,autologous peripheral blood stem cell transplantation,biotherapy and long interval maintenance therapy for 69 cases

目的观察大剂量化疗、自体外周血干细胞移植、生物治疗、长间歇维持化疗序贯治疗急性白血病的临床疗效。方法自2001年3月-2009年12月对第三军医大学新桥医院69名急性白血病患者进行大剂量化疗、自体外周血干细胞移植、白介素-2（IL-2）生物治疗、长间歇维持化疗序贯治疗,其中,急性淋巴细胞白血病（ALL）40例,急性髓细胞白血病（AML）29例,观察临床疗效和并发症。结果除1例ALL外,68名患者移植后造血功能均快速重建。急性淋巴细胞白血病首次完全缓解（ALL-CR1）25例,其中无病存活17例,带病存活2例,死亡6例,急性淋巴细胞白血病再次完全缓解（ALL-CR2）15例,其中无病存活3例,带病存活3例,死亡9例;急性髓细胞白血病首次完全缓解（AML-CR1）17,其中无病存活10例,带病存活2例,死亡5例,急性髓细胞白血病再次完全缓解（AML-CR2）12例,其中无病存活5例,带病存活1例,死亡6例。结论该序贯疗法治疗急性白血病安全有效,CR1患者较CR2患者疗效更好。

Objective To evaluate the efficacy of acute leukemia treated by high-dose chemotherapy,autologous peripheral blood stem cell transplantation,biotherapy and long interval maintenance therapy for 69 cases.Methods Sixty-nine patients（ALL in 40 cases,AML in 29 cases）with acute leukemia were treated by high-dose chemotherapy,autologous peripheral blood stem cell transplantation,biotherapy of IL-2 and long interval maintenance therapy from May 2001 to December 2006.Therapeutic effect and complication were observed.Results Sixty-eight patients obtained hematopoieteic reconstitution quickly,while one case failed.ALL-CR1（first time CR）： 17 in disease free survival（DFS）,2 in live with disease（LWD）,6 in death;ALL-CR2（second time CR）： 3 in DFS,3 in LWD,9 in death;AML-CR1：10 in DFS,2 in LWD,5 in death;AML-CR2： 5 in DFS,1 in LWD,6 in death.Conclusion Serial therapy which consists of high-dose chemotherapy,autologous peripheral blood stem cell transplantation,biotherapy and long interval maintenance therapy are safe and effective for hematologic malignancies.