摘要
目的观察FABC预处理异基因造血干细胞移植治疗未缓解急性白血病(AL)患者的疗效及安全性。方法收集2005年11月至2010年8月广东省人民医院采用FABC预处理方案进行异基因造血干细胞移植治疗18例难治未缓解AL患者。观察造血恢复、植入率、急慢性移植物抗宿主病发生率、移植相关病死率、复发、总存活率和无病存活率及预后因素分析。结果所有患者均于移植后14~21 d获得完全供者植入,中性粒细胞>0.5×109/L和血小板>20×109/L中位时间分别为12(7~72)d和13(7~60)d;急性移植物抗宿主病(GVHD)及慢性GVHD累积发生率分别为50%和73.3%。中位随访10.5(3.1~66.6)个月,移植相关病死率5.6%(1/18),复发率为36.8%(7/18)。1年的预期总生存(OS)率和无病生存(DFS)率分别是(58.9±13.2)%和(53.6±15.5%)。COX逐步回归模型分析显示,慢性GVHD是DFS独立有利因素。结论 FABC预处理异基因造血干细胞移植是治疗难治性未缓解AL安全有效的方法。
Objective To explore the efficacy and safety of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with FABC conditioning regimen for treatment of refractory unremitting acute leukemia patients. Methods Eighteen patients with refractory unremitting acute leukemia underwent allo-HSCT with FABC condi- tioning regimen. Hemopoietic recovery, engraftment, acute/chronic graft versus host disease (GVHD) , transplanta- tion-related mortality (TRM), relapse, overall survival (OS) and disease free survival (DFS) post-HSCT were analyzed. Results All of these patients attained fully donor engraftment between days 14 and 21 post transplantation. The median time to ANC 〉 0. 5 × 10^9/L and PLT 〉 20 × 10^9/L was 12(range 7 -72) and 13(range 7 - 60) days after transplantation, respectively. The cumulative incidence of acute and chronic GVHD was 50% (9/18) and 73.3% (11/15 ), respectively. During follow-up for a mean of 10. 5 (range 3. 1 -66. 6 ) months post transplantation, the TRM was 5.6% ( 1/18 ) and the relapse rate was 38. 6% (7/18). The one-year overall survival (OS) probability and disease-free survival (DFS) was (58.9 ± 13.2)% and (53.6 ±15.5 )% , respectively. Multivariate analyses by the stepwise Cox regression, chronic GVHD was shown to be an independent factor favoring DFS. Conclusion Allo-HSCT by FABC conditioning regimen is a safe and effective option for refractory unremitting acute leukemia patients.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2011年第9期687-689,共3页
Chinese Journal of Practical Internal Medicine
基金
国家自然科学基金项目(30972790
81070445)
广东省自然科学基金项目(10151008004000024)
广东省科技计划项目(2009A030200009)
关键词
难治性未缓解急性白血病
异基因造血干细胞移植
移植物抗宿主病
refractory incomplete remission acute leukemia
allogeneic hematopoietic stem cell transplantation
graft versus host disease