异基因造血干细胞移植治疗染色体核型预后中等急性髓系白血病

发布时间：2018-03-21 22:40

  本文选题：白血病　切入点：髓样　出处：《中国组织工程研究》2017年09期 　论文类型：期刊论文

【摘要】：背景:以往研究显示完全缓解期染色体核型预后中等的急性髓系白血病患者行亲缘全相合异基因外周血造血干细胞移植有较高的无病生存率和总体生存率,但影响移植预后的相关因素并未完全明确。目的:评价HLA相合异基因外周血造血干细胞移植治疗完全缓解期染色体核型预后中等急性髓系白血病的疗效,并对预后相关因素进行分析。方法:对2009年1月至2015年1月进行HLA全相合异基因外周血造血干细胞移植的50例完全缓解期染色体核型预后中等的急性髓系白血病患者进行回顾性分析,计算总体生存率,并对影响预后的各因素进行统计学分析。结果与结论:(1)4年总体生存率为64%,累积复发率及移植相关非复发死亡率分别为18%及20%。急性移植物抗宿主病的总体发生率为26%;(2)女性供者男性受者配对移植患者4年总体生存率低于非女性供者男性受者移植患者(P=0.041);移植前大于1个疗程才能达完全缓解的患者4年总体生存率低于移植前1个疗程能达完全缓解的患者(P=0.038);年龄≥40岁的患者4年总体生存率低于年龄40岁的患者(P=0.056);亲缘供者移植和非亲缘移植患者的4年总体生存率差异无显著性意义(P=0.427)。女性供者男性受者移植及年龄≥40岁患者移植相关非复发死亡率明显增高(P值分别为0.024和0.043);(3)多因素分析确认,与移植预后相关的因素有:女性供者男性受者配对移植(P=0.031,RR=1.38,95%CI 1.03-1.95)、移植前大于1个疗程才能达完全缓解(P=0.016,RR=1.46,95%CI 1.10-1.98)、年龄≥40岁(P=0.024,RR=1.63,95%CI 1.32-2.12);(4)结果表明,HLA全相合异基因外周血造血干细胞移植是染色体核型预后中等急性髓系白血病缓解后治疗的有效方法。女性供者男性受者配对移植、移植前大于1个疗程才能达完全缓解、年龄≥40岁是影响这类患者预后的主要危险因素。这类患者行异基因外周血造血干细胞移植时,供者受者的性别组合比是否为亲缘供者更为重要。
[Abstract]:Background: previous studies have shown that patients with moderate chromosome karyotype in complete remission stage of acute myeloid leukemia receiving allogeneic allogeneic peripheral blood stem cell transplantation have higher disease-free survival rate and overall survival rate. Objective: to evaluate the effect of allogeneic peripheral blood stem cell transplantation (PBSCT) on the prognosis of moderate acute myeloid leukemia (MARL) in complete remission stage. Methods: from January 2009 to January 2015, 50 patients with HLA allogeneic peripheral blood stem cell transplantation (PBSCT) with moderate prognosis of chromosome karyotype in complete remission stage were analyzed. The patients were analyzed retrospectively. To calculate the overall survival rate, Results and conclusions the overall 4 year survival rate was 64%, cumulative recurrence rate and transplant related non-recurrent mortality were 18% and 20% respectively. The overall incidence of acute graft-versus-host disease was 20%. The overall 4 year survival rate of female donors and male recipients was lower than that of non-female male recipients, and the overall 4 year survival rate of patients with complete remission before transplantation was lower than that of patients with complete remission before transplantation. The 4-year overall survival rate of the patients aged more than 40 years was lower than that of the patients aged 40 years. There was no significant difference in the 4-year overall survival rate between the patients with relative donor transplantation and those with unrelated transplantation. The mortality of male recipients and patients aged 鈮，

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