摘要
目的分析白血病患者异基因造血干细胞移植(allo—HSCT)后早期淋巴细胞计数与移植预后的关系。方法收集2003年1月至2011年4月行allo—HSCT的124例白血病患者资料,回顾性分析移植后第30天淋巴细胞计数(1ymphocytecountonday30,LC30)与5年总生存(0s)率、5年复发率(RR)、5年非复发死亡(NRM)率、急性移植物抗宿主病(aGVHD)累积发生率及慢性移植物抗宿主病(cGVHD)累积发生率之间的关系。结果单因素分析提示,LC30≥0.40×10’/L患者和LC30〈0.40×10。/L患者相比,5年0s率明显升高[(62.2-4-5.8)%对(37.0±8.6)%,P=0.003],5年RR明显降低[(13.9-4-4.7)%对(32.0-4-8.4)%,P=0.027],5年NRM率明显降低[(31.3±5.8)%对(45.0±9.3)%,P=0.048],cGVHD累积发生率明显升高[(82.9±4.6)%对(62.7±11.1)%,P=0.042]。多因素分析提示LC30与5年OS率、5年RR、5年NRM率、cGVHD累积发生率均相关,同时也发现移植前疾病危险分层与预后相关。结论allo—HSCT后早期淋巴细胞计数可作为白血病allo-HSCT后独市的预后指标.并可根据LC30{井行早期干预治疗。
Objective To analyze the correlation between early lymphocyte count (lymphocyte count on day 30, LC30) post-allogeneic hematopoietic stem cell transplantation(allo-HSCT) and transplant progno- sis in leukemia patients. Methods The data from 124 consecutive patients undergoing allo-HSCT for leuke- mia from January 2003 to April 2011 was analyzed retrospectively. LC30 post-allo-HSCT correlated with 5- year overall survival (OS) , 5-year relapse rate (RR) , 5-year nonrelapse mortality ( NRM ) , accumulative rate of acute graft versus host disease (aGVHD)and chronic graft versus host disease(cGVHD) was studied. Re- suits Univariate analysis indicated that patients with LC30≥0.40 x 109/L had higher 5-year OS than those with LC30 〈 0.40 x 109/L [ (62.2± 5.8 ) % vs ( 37.0 ± 8.6 ) %, P = 0. 003 ], lower 5-year RR [ ( 13.9 ± 4.7)% vs(32.0±8.4)%,P=0.0271, lower5-year NRM [(31.3 +5.8)% vs(45.0±9.3)%,P= 0. 048 ) ], and higher cGVHD cumulative incidence [ ( 82.9 ± 4.6 ) % vs ( 62.7 ± 11.1 ) %, P = 0. 042 ) ]. Multivariate analysis also suggested that LC30 was associated with 5-year OS, 5-year RR,5-year NRM, and cGVHD cumulative incidence. At the same time disease risk stratification was associated with prognosis. Conclusions Early lymphocyte count (LC30) post-allogeneic hematopoietic stem cell transplantation in leu- kemia is highly associated with prognosis, which can be the independent prognosis index after allo-HSCT in leukemia and can identify a group of patients who might be suitable candidates for early interventions treat- ment.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2012年第8期632-636,共5页
Chinese Journal of Hematology
关键词
白血病
造血干细胞移植
早期淋巴细胞计数
预后
Leukemia
Hematopoietic stem cell transplantation
Early lymphocyte count
Prognosis