中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2011年
11期
729-733
,共5页
陈佳%陈峰%孙爱宁%仇惠英%韩悦%唐晓文%傅铮铮%苗瞄%何广胜%金正明%吴德沛
陳佳%陳峰%孫愛寧%仇惠英%韓悅%唐曉文%傅錚錚%苗瞄%何廣勝%金正明%吳德沛
진가%진봉%손애저%구혜영%한열%당효문%부쟁쟁%묘묘%하엄성%금정명%오덕패
白血病%造血干细胞移植%复发
白血病%造血榦細胞移植%複髮
백혈병%조혈간세포이식%복발
Leukemia%Hematopoietic stem cell transplantation%Relapse
目的 分别统计分析急性淋巴细胞白血病(ALL)、急性髓系白血病(AML)和慢性髓系白血病(CML)患者行异基因造血干细胞移植(allo-HSCT)后复发的高危因素,比较各高危因素的影响并初步分析其影响机制.方法 单中心回顾性研究,以近8年来接受allo-HSCT的262例可评价的白血病患者为研究对象,其中ALL 69例,AML(除外急性早幼粒细胞白血病)90例,CML 103例,采用COX比例风险模型对移植前多项指标进行单因素及多元分析,筛选移植后复发的高危因素.结果 显著影响移植后复发风险的因素因疾病类型不同有所差异.ALL:染色体危险度分层、初始诱导疗程；AML:染色体危险度分层、移植前微量残留病灶水平、白细胞重建时间和移植物中CD4+/CD8+细胞比值；CML:移植前病期.结论 ALL患者移植后复发风险主要取决于本病的危险度,而AML患者移植后复发与移植过程中的多项指标也密切相关,CML患者在移植前保持病情稳定有利于避免移植后复发.染色体危险度分层是影响移植后复发的主要危险因素.
目的 分彆統計分析急性淋巴細胞白血病(ALL)、急性髓繫白血病(AML)和慢性髓繫白血病(CML)患者行異基因造血榦細胞移植(allo-HSCT)後複髮的高危因素,比較各高危因素的影響併初步分析其影響機製.方法 單中心迴顧性研究,以近8年來接受allo-HSCT的262例可評價的白血病患者為研究對象,其中ALL 69例,AML(除外急性早幼粒細胞白血病)90例,CML 103例,採用COX比例風險模型對移植前多項指標進行單因素及多元分析,篩選移植後複髮的高危因素.結果 顯著影響移植後複髮風險的因素因疾病類型不同有所差異.ALL:染色體危險度分層、初始誘導療程；AML:染色體危險度分層、移植前微量殘留病竈水平、白細胞重建時間和移植物中CD4+/CD8+細胞比值；CML:移植前病期.結論 ALL患者移植後複髮風險主要取決于本病的危險度,而AML患者移植後複髮與移植過程中的多項指標也密切相關,CML患者在移植前保持病情穩定有利于避免移植後複髮.染色體危險度分層是影響移植後複髮的主要危險因素.
목적 분별통계분석급성림파세포백혈병(ALL)、급성수계백혈병(AML)화만성수계백혈병(CML)환자행이기인조혈간세포이식(allo-HSCT)후복발적고위인소,비교각고위인소적영향병초보분석기영향궤제.방법 단중심회고성연구,이근8년래접수allo-HSCT적262례가평개적백혈병환자위연구대상,기중ALL 69례,AML(제외급성조유립세포백혈병)90례,CML 103례,채용COX비례풍험모형대이식전다항지표진행단인소급다원분석,사선이식후복발적고위인소.결과 현저영향이식후복발풍험적인소인질병류형불동유소차이.ALL:염색체위험도분층、초시유도료정；AML:염색체위험도분층、이식전미량잔류병조수평、백세포중건시간화이식물중CD4+/CD8+세포비치；CML:이식전병기.결론 ALL환자이식후복발풍험주요취결우본병적위험도,이AML환자이식후복발여이식과정중적다항지표야밀절상관,CML환자재이식전보지병정은정유리우피면이식후복발.염색체위험도분층시영향이식후복발적주요위험인소.
Objective To screen the high risk factors for relapse after allogeneic hematopoietic stem cell transplantation(allo-HSCT) in acute lymphocytic leukemia (ALL),acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) respectively,then to compare the contribution of each risk factor to relapse and investigate the relevant mechanisms.Methods A retrospective study from single center involved in 262evaluable cases of leukemia received allo-HSCT over the past 8 years,of them 69 cases with ALL,90 AML ( except APL) and 103 CML.Cox proportional hazard regression model was used for univariate and multivariate analysis to screen the high risk factors.Results The risk factors significantly affecting relapse in ALL included:Cytogenetic risk classification,the cycles of initial induction chemotherapy; AML:Cytogenetic risk classification,minimal residual disease (MRD) level before transplant,reconstitution of WBC,and CD4+/CD8 + lymphocyte ratio in the graft; CML:disease stage before transplant.Conclusions The relapse risk after HSCT of ALL mainly depends on the grade of malignancies,and the relapse risk of AML is closely related to the course of transplant.Chronic phase of CML favors a good prognosis after HSCT.Cytogenetic risk classification is the most relevant predictor of relapse after HSCT.
