异基因骨髓移植治疗慢性髓系白血病118例分析

Allogeneic bone marrow transplantation for chronic myeloid leukemia:118 cases analysis

目的 分析异基因骨髓移植治疗慢性髓系白血病患者长期存活的影响因素。方法采用ＴＢＩ 或改良ＢＵ／ＣＹ 预处理方案进行异基因骨髓移植，治疗慢性髓系白血病。１１８ 例患者中慢性期９１ 例，加速期１９ 例，急变期２ 例，第２ 次以上慢性期６ 例。结果 １０９ 例植活。慢性期和加速期患者的５ 年存活概率分别为６９ ．６ ％ 和５１ ．０ ％ ；５ 年复发概率分别为３ ．２ ％ 和１２ ．５ ％ 。结论 病期、预处理方案和脾大对植活时间无影响， 慢性期患者脾大与复发呈正相关； 两种预处理方案对慢性期患者移植效果的影响，差异无显著性。

Objective To analyze the outcome of allogeneic bone marrow transplantation (allo BMT) performed for chronic myeloid leukemia (CML) patients. Methods One hundred and eighteen CML patients received allo BMT with conditioning regimens of TBI or modified BU/CY. The pre BMT situations were, 91 cases in first chronic phase (CP1), 19 in accelerating phase (AP), 2 in blast crisis (BC) and 6 in advanced CP (>CP2). Results One hundred and nine patients were successfully engrafted. The probabilities of 5 year suvival for CP1 and AP patients were 69.6%and 51.0%, and 5 year relapse rates were 3.2%and 12.5%, respectively. Conclusions Disease stage, conditioning regimen and splenomegaly did not affect the time for engraftment. For patients in CP1,splenomegaly was positively correlated with relapse. There was no difference between the effect of the two conditioning regimens on the prognosis.