HLA半相合造血干细胞移植治疗首次复发的急性髓系白血病
HLA반상합조혈간세포이식치료수차복발적급성수계백혈병
Haploidentical hematopoietic stem-cell transplantation for acute myeloid leukemia in first relapse after complete remission by standard induction chemotherapy
  • 万方数据
    中华器官移植杂志 중화기관이식잡지
    CHINESE JOURNAL OF ORGAN TRANSPLANTATION
    2011年 3期 141-143 ,共3页

    郭坤元%宋朝阳%吴秉毅%李玉华%邓兰%苏毅%陈建%邵文斌%孙薏%王三斌%李达%吴远彬%胡永珍%鹿全意

    곽곤원%송조양%오병의%리옥화%산란%소의%진건%소문빈%손의%왕삼빈%리체%오원빈%호영진%록전의

    白血病,髓样,急性%复发%造血干细胞移植%HLA抗原 白血病,髓樣,急性%複髮%造血榦細胞移植%HLA抗原
    백혈병,수양,급성%복발%조혈간세포이식%HLA항원
    Leukemia,myeloid,acute%Recurrence%Hematopoietic stem cell transplantation%HLA antigens
    目的 探讨遗传上HLA半相合外周血造血干细胞移植(Haplo-PBSCT)对首次复发后的成人急性髓系白血病(AML)的治疗效果.方法 89例成人AML患者接受常规柔红霉素-高剂量阿糖胞苷(DA/Hi-Ara-C)化疗缓解后出现首次复发,其中复发后接受Haplo-PBSCT治疗者53例,平均年龄38.6岁(18～51岁),复发时间为首次缓解后7.7个月(1～24个月);接受去甲氧柔红霉素-中剂量阿糖胞苷(iDA/Mid-Ara-C)或米托蒽醌-中剂量阿糖胞苷(MA/Mid-Ara-C)方案继续化疗者26例,平均年龄47.6岁(18～61岁),复发时间为首次缓解后8.9个月(1～30个月).结果 接受Haplo-PBSCT治疗者和接受化疗者再次完全缓解率(CR)分别为86.7%(46/53)和38.1%(9/23),两者比较,差异有统计学意义(P＜0.01).接受Haplo-PBSCT治疗者和接受化疗者36个月的疾病进展后存活(SPP)率分别为43.4%(23/53)和11.5%(3/26),两者比较,差异有统计学意义(P＜0.05).结论 相对于接受iDA/Mid-Ara-C或MA/Mid-Ara-C方案继续化疗者,Haplo-PBSCT能明显提高首次复发后AML患者的再次缓解率以及延长SPP时间.
    목적 탐토유전상HLA반상합외주혈조혈간세포이식(Haplo-PBSCT)대수차복발후적성인급성수계백혈병(AML)적치료효과.방법 89례성인AML환자접수상규유홍매소-고제량아당포감(DA/Hi-Ara-C)화료완해후출현수차복발,기중복발후접수Haplo-PBSCT치료자53례,평균년령38.6세(18～51세),복발시간위수차완해후7.7개월(1～24개월);접수거갑양유홍매소-중제량아당포감(iDA/Mid-Ara-C)혹미탁은곤-중제량아당포감(MA/Mid-Ara-C)방안계속화료자26례,평균년령47.6세(18～61세),복발시간위수차완해후8.9개월(1～30개월).결과 접수Haplo-PBSCT치료자화접수화료자재차완전완해솔(CR)분별위86.7%(46/53)화38.1%(9/23),량자비교,차이유통계학의의(P＜0.01).접수Haplo-PBSCT치료자화접수화료자36개월적질병진전후존활(SPP)솔분별위43.4%(23/53)화11.5%(3/26),량자비교,차이유통계학의의(P＜0.05).결론 상대우접수iDA/Mid-Ara-C혹MA/Mid-Ara-C방안계속화료자,Haplo-PBSCT능명현제고수차복발후AML환자적재차완해솔이급연장SPP시간.
    Objective To investigate the therapeutic effects of haploidentical hematopoietic stem-cell transplantation (Haplo-PBSCT) for acute myeloid leukemia in first relapse after complete remission by standard induction chemotherapy. Methods Eighty-nine cases of AML in first relapse after complete remission by standard DA/Hi-Ara-C regimens induction chemotherapy were evaluated retrospectively. Fiftythree cases were grafted by haplo-PBSCT and 26 cases were treated with iDA/Mid-Ara-C or MA/ Mid- Ara-C agents. Results The second remission rate in haplo-PBSCT group and continuous chemotherapy group was 86. 7 % (46/53 cases) and 38. 1% (9/23 cases) respectively (P＜0. 01). Survival postprogression (SPP) at 36th month was 43. 4 % (23/53 cases) in haplo-PBSCT group and 11.5 % (3/26 cases) in continuous chemotherapy group (P ＜ 0. 05). Conclusion Haplo-PBSCT could significantly increase the second remission rate and prolong the survival time of patients with acute myeloid leukernia in first relapse after complete remission by standard induction chemotherapy.
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