自体及异基因造血干细胞移植治疗急性髓细胞白血病的临床疗效

Clinical efficacy of autologous and allogeneic hematopoietic stem cell transplantation for patients with acute myeloid leukemia

目的探讨自体及异基因造血干细胞移植治疗急性髓细胞白血病(AML)的临床疗效。方法中等预后AML患者42例分为两组。A组16例,采用大剂量去甲氧柔红霉素(IDA)及白消安(Bu)预处理(I-Bu方案)联合自体造血干细胞移植(ASCT)治疗;B组26例,采用Bu及环磷酰胺预处理(Bu-Cy方案)联合HLA全相合同胞供者异基因造血干细胞移植(allo-HSCT)。比较两组患者的疗效及不良反应。结果两组患者均达到造血重建。A组和B组患者中位总生存期(OS)分别为26个月和25个月(P=0.222),中位无病生存期(DFS)分别为21个月和19个月(P=0.287),24个月累积复发率分别为42.7%和26.9%(P=0.656)。与B组比较,A组不良反应较轻。结论 I-Bu预处理方案联合ASCT作为中等预后AML的缓解后治疗更为安全有效。

Objective To investigate the efficacy of autologous and allogeneic hematopoietic stem cell transplantation for the patients with acute myeloid leukemia（AML）.Methods A total of 42 AML patients was divided into two groups.The patients in group A（16cases）were treated with autologous hematopoietic stem cell transplantation（ASCT）with high-dose idarubicin and busulfan（IBu）as conditioning regimen.The patients in group B（26 cases）were treated with allogeneic hematopoietic stem cell transplantation（allo-HSCT）of HLA-identical sibling donors with Bu and cyclophosphamide（Bu-Cy）as conditioning regimen.The efficacy and toxicity of two groups were compared.Results The patients of two groups obtained hematopoietic reconstitution.Median overall survival（OS）,median disease-free survival（DFS）and cumulative relapse incidence in 24 months after diagnosis in groups of A and B were 26 months and 25months（P=0.222）,21 months and 19months（P=0.287）,and 42.7% and 26.9%（P=0.656）,respectively.Complications in group A were less than those in group B.Conclusion I-Bu as conditioning regimen with ASCT seems to be better than Bu-Cy with allo-HSCT in the treatment of AML patients with intermediate-prognosis.