自体造血干细胞移植治疗急性白血病的研究进展

Autologous hematopoietic stem cell transplantation for acute leukemia

经过近40年的发展，自体造血干细胞移植（AHSCT）在急性白血病治疗中的地位和作用不断变化。AHSCT的主要优势为移植相关死亡率低和移植后患者生活质量高，其主要问题为移植后复发率高。预后良好及不适合异基因造血干细胞移植（allo-HSCT）的急性髓细胞白血病（AML）患者可受益于AHSCT；在酪氨酸激酶抑制剂（TKI）靶向治疗时代，对TKI反应良好的Ph＋-急性淋巴细胞白血病（ALL）患者进行AHSCT治疗后，可提高其远期生存质量。为了提高AHSCT治疗急性白血病的疗效，AML患者应在化疗缓解后强化治疗2～3个疗程进行AHSCT治疗，ALL患者则应在化疗缓解后强化治疗3～5个疗程进行为宜。ALL患者在接受AHSCT治疗后，还应进行移植后维持治疗。

During the latest 40 years, the role of autologous hematopoietic stem cell transplantation （AHSCT） as consolidation therapy for adult patients with acute leukemia has changed. Patient after AHSCT treatment has low transplantation related mortality and good quality of life. However, the relapse rate after AHSCT is high. Favorable acute myeloid leukemia （AML） and AML patients who are not suitable for allergenic hematopoietic stem cell transplantation （allo-HSCT） can benefit from AHSCT. In the era of tyrosine kinase inhibitor （TKI） targented therapy, Ph＋-acute lymphoblastic leukemia （ALL） patients who have good response to TKI therapy have long-term quality of life after AHSCT treatment. To improve the curative effect of AHSCT treatment for acute leukemia, AHSCT should better be done after two to three chemotherapies for AML patients and three to five chemotherapies for ALL patients following complete remission. Furthermore, ALL patients should receive maintenance therapy after AHSCT.