微移植联合化疗治疗老年急性髓系白血病临床观察

Clinical observation of microtransplantation combination with induction chemotherapy in treatment for elderly patients with acute myeloid leukemia

目的:观察微移植联合化疗治疗老年急性髓系白血病患者的临床疗效及安全性。方法:回顾性分析我院35例老年急性髓系白血病患者经单纯诱导化疗(n=16)或联合微移植(n=19)的治疗过程及转归情况。结果:微移植联合化疗组14例(73.7%)完全缓解(CR),单纯诱导化疗组6例(37.5%)CR;微移植组中性粒细胞、血小板中位恢复时间分别为11.5 d、16 d,而单纯诱导化疗组则分别为15 d、22 d(P<0.05);微移植组无重症感染及相关死亡发生,单纯化疗组因重症感染死亡3例。结论:微移植联合化疗治疗老年急性髓系白血病提高了疾病缓解率,降低了化疗相关死亡率。

Objective: To explore the efficacy and adverse reactions of HLA-mismatched stem-cell microtransplantation combination with induction chemotherapy in treatment of elderly patients with acute myeloid leukemia.Methods: The data of 35 AML patients over 60 years were randomly assigned to receive induction chemotherapy( control group,16 cases) or it plus human leukocyte antigen-mismatched G-PBSCs( G-PBSC group,19 cases). Results: The CR rate in the G-PBSC group was higher than that in the control group( 73. 7% vs 37. 5%,P < 0. 05).The median recovery times for neutrophils and platelets were 11. 5 days and 15 days,respectively,in the G-PBSC group and 16 days and 22 days,respectively,in the control group after chemotherapy( P < 0. 05). No case died in the G-PBSC group. Three patients died of severe infection in the control group. No acute or chronic GVHD was observed in any of the patients. Conclusion: The combination of HLA-mismatched G-PBSC infusion with conventional chemotherapy can result in a higher CR rate,a shorter duration of pancytopenia than conventional chemotherapy alone. Microtransplantation offers an much safer and much more effective regimen for elderly patients.