异基因造血干细胞移植治疗67例移植物抗宿主病分析

Analysis of allogeneic transplantation for treatment of 67 patients with blood system diseases Graft-versus-host disease

目的探讨恶性血液病异基因造血干细胞移植(allo-HSCT)后急性移植物抗宿主病(aGVHD)和慢性移植物抗宿主病(cGVHD)的发生情况及其与预后的关系。方法回顾郑州市第三人民医院67例接受allo-HSCT患者的临床资料,分析aGVHD、cGVHD的发生情况及aGVHD、cGVHD对患者复发和生存的影响。结果 21例患者发生Ⅰ～Ⅱ度aGVHD;14例发生Ⅲ～Ⅳ度aGVHD;曾发生Ⅱ～Ⅳ度aGVHD是发生cGVHD的危险因素;发生Ⅱ～Ⅳ度aGVHD者总生存率(OS)低,重度(Ⅲ～Ⅳ)aGVHD患者的死亡率高。低危组患者复发率较低,发生cGVHD者存活率高。结论防治重度aGVHD有利于减少cGVHD的发生;重度aGVHD影响患者的生存。

Objective To investigate the correlation of occurrence and prognosis between allogeneic hematopoietic stem cell transplantation（allo-HSCT） of acute graft-versus-host disease（aGVHD） and chronic graft versus host disease（cGVHD）.Methods By reviewing 67 cases clinical data receiving allo-HSCT,with aGVHD,cGVHD occurrence and analyze influence of the recurrence and survival.Results There were 21 patients developed with Ⅰ~Ⅱ degree aGVHD,Ⅲ~Ⅳ aGVHD occurred with 14 cases.Ⅱ~Ⅳ degree aGVHD history is the main risk factors of gaining cGVHD.The overall survival（OS） of Ⅱ ~Ⅳ degree aGVHD patients shows low level.Severe（Ⅲ~Ⅳ） aGVHD patients reflected high mortality.Low-risk group shows low recurrence,and the cases with cGVHD gain high survival rate.Conclusions The treatment of severe aGVHD contribute to reduce the occurrence of cGVHD;Severe cGVHD disease decreases the survival and prognosis of hematologic malignancy patients.