异基因造血干细胞移植治疗bcr/abl融合基因阳性急性白血病的临床疗效观察

Effect of allogeneic hematopoietic stem cell transplantation on acute leukemia with bcr/abl fusion gene-positive

目的:观察异基因造血干细胞移植治疗bcr/abl融合基因阳性急性白血病的临床疗效。方法:对MICM分型确诊的18例bcr/abl融合基因阳性急性白血病患者,采用化疗或加用酪氨酸激酶抑制剂达完全缓解后行异基因造血干细胞移植术。结果:18例行异基因造血干细胞移植术后,均获得造血及免疫功能重建。9例无病存活;1例复发,经治疗后再次达完全缓解;8例死亡,其中因复发死亡3例,移植相关死亡5例。2a无病生存率为(31.6±14.0)%,2a总生存率为(48.0±13.9)%;中位无病生存时间(9.0±3.1)个月,中位总生存时间(18.0±8.0)个月。结论:异基因造血干细胞移植是目前治愈bcr/abl融合基因阳性急性白血病的惟一有效手段,联合酪氨酸激酶抑制剂能有效提高长期生存率。

Aim： To observe the effect of allogeneic hematopoietic stem cell transplantation（AHSCT） on acute leuke- mia with bcr/abl fusion gene-positive. Methods：A total of 18 cases of MICM-typing confirmed acute leukemia with positive bcr/abl fusion gene were given AHSCT, after complete remission treated by chemotherapy or combined with tyrosine kinase inhibitors. Results ： All the patients acquired hematopoietic and immune reconstitution after AHSCT, among whom 9 cases had disease-free survival; 1 case relapsed and achieved complete remissi.on again after treatment ; and the other 8 cases died, including 3 cases of relapse and 5 cases of transplantation related mortality. The rate of 2-year disease-free and over- all survival were（31.6 ±14.0） % and （48.0 ± 13.9） % , respectively; the median disease-free survival time was（9.0 ± 3.1 ） months, and the median overall survival time was （18.0± 8.0） months, respectively. Conclusion： AHSCT is cur- rently the only effective means of curing bcr/abl fusion gene-positive acute leukemia;AHSCT combined with tyrosine kinase inhibitor can significantly improve long-term survival.