以IBu为预处理方案的自体外周血造血干细胞移植治疗低、中危急性髓系白血病11例

发布时间：2018-05-14 03:12

本文选题：自体造血干细胞移植 + 急性髓系白血病　；参考：《中国实验血液学杂志》2017年01期

【摘要】：目的:分析用大剂量伊达比星(IDA)联合马利兰(Bu)组成的IBu预处理方案对自体外周血造血干细胞移植(auto-PBHSCT)治疗低、中危急性髓系白血病(AML)的安全性及疗效。方法:对2011年3月至2014年7月在本院以IBu预处理方案(IDA 20 mg/m2,持续静脉滴注,移植前13至移植前11 d;Bu 0.8 mg/kg,6 h 1次,静脉滴注2h,移植前5至移植前2 d)的auto-PBHSCT治疗的11例低、中危AML(低危5例,中危6例)进行了回顾性分析,记录不良反应和移植相关死亡(TRM)。以Kaplan-Meier法计算总生存率(OS)、无病生存率(DFS)和累积复发率(RR),以Cox回归对DFS进行单因素分析。结果:10例患者获造血重建,1例患者在移植过程中死亡,TRM为9.1%。患者对不良反应耐受性良好。中位随访31.6(8.7-52.5)个月,结果7例患者(63.3%)仍然存活,其中6例患者(54.5%)处于持续完全缓解(CR)状态,中位OS及DFS未能获得;3年OS为(57.7±16.3)%,3年DFS为(52.5±17.6)%,3年RR为47.5%。单因素分析显示,患者年龄、性别、诊断至移植间隔时间、初诊时白细胞计数、危险度分组(低危或中危)、移植前疾病状态(CR1或CR2)、回输单个核细胞数对DFS均无明显影响(均P0.05)。结论:以IBu为预处理方案的auto-PBHSCT治疗低、中危AML的安全性及疗效均良好。
[Abstract]:Objective: to analyze the safety and efficacy of a IBu preconditioning regimen composed of large dose of IDA and Bu in the treatment of low and moderate acute myeloid leukemia (AML) with autologous peripheral blood stem cell transplantation (auto-PBHSCT). Methods: IBu preconditioning (IDA 20 mg/m2, continuous intravenous drip from March 2011 to July 2014). Note: 13 to 11 d before transplantation; 11 cases of auto-PBHSCT treatment with 0.8 mg/kg, 6 h, 1 times, intravenous drip 2h, 5 to 2 D before transplantation; a retrospective analysis of middle risk AML (low risk 5 cases, and 6 cases), recorded adverse reactions and transplant related deaths (TRM). The total survival rate (OS), disease free survival (DFS) and accumulation were calculated by Kaplan-Meier. The recurrence rate (RR) and single factor analysis of DFS were performed with Cox regression. Results: 10 patients received hematopoietic reconstitution, 1 patients died during the transplantation, TRM was 9.1%. patient with good tolerance to adverse reactions. Median follow-up was 31.6 (8.7-52.5) months, and 7 patients (63.3%) still survived, of which 6 patients (54.5%) were in continuous complete remission (CR). The median OS and DFS were not obtained. 3 years OS was (57.7 + 16.3)%, 3 year DFS was (52.5 + 17.6)%, and 3 year RR was 47.5%. single factor analysis. The patient's age, sex, diagnosis to transplantation interval, leukocyte count at first diagnosis, risk group (low or middle risk), pre transplant disease state (CR1 or CR2), and the number of single nucleus cells returned to the patients had no significant effect on DFS ( All P0.05). Conclusion: the safety and efficacy of auto-PBHSCT treated with IBu as preconditioning regimen are low and AML is good.

【作者单位】：苏州大学附属第三医院常州市第一人民医院血液科;
【分类号】：R457.7;R733.71

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