CAJ | 학술논문

目的分析白血病患者异基因造血干细胞移植(allo-HSCT)后早期淋巴细胞计数与移植预后的关系.方法收集2003年1月至2011年4月行allo-HSCT的124例白血病患者资料,回顾性分析移植后第30天淋巴细胞计数(lymphocyte count on day 30,LC30)与5年总生存(OS)率、5年复发率(RR)、5年非复发死亡 (NRM) 率、急性移植物抗宿主病(aGVHD)累积发生率及慢性移植物抗宿主病(cGVHD)累积发生率之间的关系.结果单因素分析提示,LC30≥0.40×109/L患者和LC30＜0.40×109/L患者相比,5年OS率明显升高[(62.2±5.8)% 对(37.0±8.6)%,P=0.003],5年RR明显降低[(13.9±4.7)% 对(32.0±8.4)%,P=0.027],5年NRM率明显降低[(31.3±5.8)% 对(45.0±9.3)%,P=0.048],cGVHD累积发生率明显升高[(82.9±4.6)% 对(62.7±11.1)%,P=0.042].多因素分析提示LC30与 5年OS率、5年RR、5年NRM率、cGVHD累积发生率均相关,同时也发现移植前疾病危险分层与预后相关.结论 allo-HSCT后早期淋巴细胞计数可作为白血病allo-HSCT后独立的预后指标,并可根据LC30进行早期干预治疗.
목적 분석백혈병환자이기인조혈간세포이식(allo-HSCT)후조기림파세포계수여이식예후적관계.방법 수집2003년1월지2011년4월행allo-HSCT적124례백혈병환자자료,회고성분석이식후제30천림파세포계수(lymphocyte count on day 30,LC30)여5년총생존(OS)솔、5년복발솔(RR)、5년비복발사망 (NRM) 솔、급성이식물항숙주병(aGVHD)루적발생솔급만성이식물항숙주병(cGVHD)루적발생솔지간적관계.결과 단인소분석제시,LC30≥0.40×109/L환자화LC30＜0.40×109/L환자상비,5년OS솔명현승고[(62.2±5.8)% 대(37.0±8.6)%,P=0.003],5년RR명현강저[(13.9±4.7)% 대(32.0±8.4)%,P=0.027],5년NRM솔명현강저[(31.3±5.8)% 대(45.0±9.3)%,P=0.048],cGVHD루적발생솔명현승고[(82.9±4.6)% 대(62.7±11.1)%,P=0.042].다인소분석제시LC30여 5년OS솔、5년RR、5년NRM솔、cGVHD루적발생솔균상관,동시야발현이식전질병위험분층여예후상관.결론 allo-HSCT후조기림파세포계수가작위백혈병allo-HSCT후독립적예후지표,병가근거LC30진행조기간예치료.
Objective To analyze the correlation between early lymphocyte count (lymphocyte count on day 30, LC30) post-allogeneic hematopoietic stem cell transplantation(allo-HSCT) and transplant prognosis in leukemia patients. Methods The data from 124 consecutive patients undergoing allo-HSCT for leukemia from January 2003 to April 2011 was analyzed retrospectively. LC30 post-allo-HSCT correlated with 5-year overall survival(OS), 5-year relapse rate(RR), 5-year nonrelapse mortality(NRM), accumulative rate of acute graft versus host disease (aGVHD)and chronic graft versus host disease(cGVHD) was studied. Results Univariate analysis indicated that patients with LC30≥0.40×109/L had higher 5-year OS than those with LC30 ＜0.40×109/L [(62.2±5.8)% vs(37.0±8.6)%,P=0.003], lower 5-year RR[(13.9±4.7)% vs(32.0±8.4)%,P=0.027], lower 5-year NRM [(31.3±5.8)% vs(45.0±9.3)%,P=0.048)],and higher cGVHD cumulative incidence [(82.9±4.6)% vs(62.7±11.1)%,P=0.042)]. Multivariate analysis also suggested that LC30 was associated with 5-year OS,5-year RR,5-year NRM, and cGVHD cumulative incidence. At the same time disease risk stratification was associated with prognosis. Conclusions Early lymphocyte count (LC30) post-allogeneic hematopoietic stem cell transplantation in leukemia is highly associated with prognosis, which can be the independent prognosis index after allo-HSCT in leukemia and can identify a group of patients who might be suitable candidates for early interventions treatment.