自体外周血造血干细胞和自体骨髓移植治疗急性髓性白血病的临床疗效比较研究

Autologous peripheral blood stem cell Transplantation versus bone marrow transplantation for acute myeloid leukemia

目的 :比较自体外周血干细胞移植 (APBSCT)与自体骨髓移植治疗CR1期急性髓性白血病 (AML)的临床疗效。方法 :用APBSCT治疗AML患者 2 7例 ,用非净化自体骨髓移植 (ABMT)治疗AML患者 13例 ,用净化自体骨髓移植 (PABMT)治疗AML患者 2 5例。结果 :①APBSCT组造血重建较其他两组显著加快 ;②APB SCT组的 3年无病生存率 (DFS)和复发率 (RR)分别为 5 1.9%和 42 .2 % ,与ABMT组的 46.2 %、46.7%相当 ,但与净化ABMT组的 72 .9%、2 3 .7%相比差异有显著性意义。③三组的移植相关死亡率 (TRM )差异无显著性意义 ,死亡的主要原因为感染和内脏出血。结论 :APBSCT治疗CR1期AML ,其造血重建显著快于ABMT ,其疗效与ABMT相当 ,而显著低于PABMT。

Objective:To compare the clinical outcome of autologous peripheral blood stem cell transplantation(APBSCT) and autologous bone marrow transplantation(ABMT) in treatment of patients with acute myeloid leukemia in first remission.Method:27 patients received APBSCT, 13 received unpurged ABMT and 25 received purged ABMT. Result:①Hematopoietic recovery was significantly quicker after APBSCT than that after purged or unpurged ABMT.②After APBSCT, disease-free survival(DFS) and relapse rate (RR) was 51.9% and 42.2% respectively, and did not different significantly from that found in unpurged ABMT ( 46.2% and 46.7%), but significantly inferior to that found in purged ABMT ( 72.9% and 23.7%). The main reason for transplant-related death (TRD) were infection and hemorrhage. Conclusion:The clinical outcome of APBSCT is similar to unpurged ABMT and inferior to purged ABMT, but allows faster recovery time and reduced need for transfusion support.