异基因造血干细胞移植治疗急性白血病28例临床分析.docVIP

异基因造血干细胞移植治疗急性白血病28例临床分析王先选，王利*，肖青，王建渝，张红宾，唐晓琼，王欣，杨泽松，陈建斌，刘林重庆医科大学附属第一医院血液科，重庆 400016摘要 目的 评价异基因造血干细胞移植（allogeneic hematopoietic stem cell transplantation，allo-HSCT) 治疗急性白血病的疗效。方法 收集2005年01月～2011年08月我院行llo-HSCT的急性白血病28例，其中，急性淋巴细胞白血病7例，急性髓系白血病21例。26例为同胞全相合，2例同胞5/6相合。预处理方案22例为马利兰/环磷酰胺，3例为改良马利兰/环磷酰胺, 3例为马利兰/环磷酰胺/氟达拉滨。常规采用环孢素联合短程甲氨喋呤预防移植物抗宿主病。结果 所有患者移植后造血功能均快速重建。中位随访时间22个月，至随访结束，总生存率71.4%，其中，16例患者(57.1%)已无病生存11～79个月。未出现急性移植物抗宿主病，6例发生慢性移植物抗宿主病）。共8例于移植后死于cGVHD、感染或疾病复发。移植前首次化疗即达完全缓解者（即CR1）移植后总生存率及无病生存率均比CR2或NR患者同期增高。结论 异基因造血干细胞移植是急性白血病安全有效的治疗方法，CR1后应尽早选择异基因造血干细胞移植。[关键词] 异基因；外周血造血干细胞移植；急性白血病  Analysis of allogenetic hematopoietic stem cell transplantation for the treatment of 28 patients with acute leukemia WANG Xian-xuan, WANG Li*, XIAO Qing, WANG Jian-yu, ZHANG Hong-bin, TANG Xiao-qiong, WANG Xin, WANG Yu, YANG Ze-song, CHEN Jian-bin, LIU Lin Hematology Department, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016 Abstract: Objective To evaluate the clinical curative effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute leukemia(AL). Methods Twenty-eight patients with acute leukemia [7 cases with acute lymphoblastic leukemia (ALL), 21 cases with acute myeloid leukemia (AML)] received the treatment of allo-HSCT with HLA matched sibling donors except two cases (5/6 matched) in our hospital from January 2005 to August 2011. Twenty-two patients were pre-conditioned with busulfan (Bu) and cyclophosphamide (Cy) regimen, 3 patients with modified Bu/Cy regimen, 3 patients with fludarabine (F)/Bu/Cy regimen. The routine prevention of graft versus host disease (GVHD) consisted of methotrexate (MTX) and cyclosporine A (CsA). Results All patients were quickly achieved hematopoietic reconstitution after allo-HSCT. The median follow-up duration was 22 months. At the end of follow-up, overall survival (OS) was 71.4%, among them, 16 patients (57.1%) survived with disease-free survival (DFS) in 11 to79 months after allo-