异基因造血干细胞移植治疗骨髓增生异常综合征20例临床分析

Clinical analysis of allogeneic hematopoietic stem cell transplantation in the treatment of myelodysplastic syndrome in 20 cases

目的评价异基因造血干细胞移植(Allo-HSCT)治疗骨髓增生异常综合征(MDS)的临床疗效。方法回顾性分析2009年11月至2015年3月在重庆医科大学附属第一医院造血干细胞移植中心行Allo-HSCT的(初诊为)MDS患者20例。结果 18例获造血重建,中性粒细胞绝对值(ANC)≥0.5×109/L及PLT≥20×109/L的中位时间分别为10.5d和13.5d。所有患者随访截止于2015年3月30日,13例无病存活,其余7例死亡,其中1例死于复发,6例死于移植相关并发症。截止随访日期,本组患者的总生存率和无病生存率均为65%。结论 Allo-HSCT是治疗中高危年轻MDS患者的有效手段,可作为一线治疗尽早采用。

Objective To analyse and evaluate the clinical effects of allogeneic hematopoietic stem cell transplantation（AlloHSCT）for patients with myelodysplastic syndrome（MDS）.Methods From November 2009 to March 2015,a total of 20 patients with（primary diagnosis）MDS were treated with Allo-HSCT in the Hematopoietic Stem Cell Transplantation Center of the First Affiliated Hospital of Chongqing Medical University,including 8females and 12 males with the median age 48（16―62）years old.Results The hematopoietic system were successfully reconstructed in 18 cases,and the other 2cases had not obtained hematopoietic reconstitution.The median time of absolute neutrophil count（ANC）≥0.5×109/L and PLT≥20×109/L was 10.5（8―25）d and 13.5（10―31）d respectively.Three cases developed acute graft-versus-host disease（aGVHD）and 9cases developed chronic GVHD（cGVHD）.All patients were followed up until March 30,2015.The median follow-up time was 12.8（1.1―60.2）mon.13 cases survived with disease-free,and the other 7cases were all died,in which 1case died of recurrence and the other 6cases died of transplant related complications（TRCs）.By the end of the follow-up date,the overall survival（OS）and disease-free survival（DFS）rate were both 65.0%.The accumulated relapse rate（RR）was 5.0%,and the transplant-related mortality（TRM）and nonrelapse mortality（NRM）rates were both 30.0%.Conclusion Allo-HSCT is an effective method for the treatment of intermediaterisk and high-risk young patients with MDS,and should be the first choice of treatment and performed as early as possible.