CAJ | 학술논문

目的分析异基因造血干细胞移植(allo-HSCT)治疗伴有Fms样酪氨酸激酶3基因内部串联重复(FLT3-ITD)阳性的急性髓性白血病(AML)的疗效,探讨不同移植方式及疾病状态对该类患者预后的影响.方法 2006年10月至2012年10月在苏州大学附属第一医院行allo-HSCT的AML患者共314例,其中FLT3-ITD阳性54例,回顾性分析allo-HSCT对FLT3-ITD阳性AML患者的临床疗效.结果 54例FLT3-ITD阳性患者3年总生存(OS)率为56％,3年无白血病生存(LFS)率为47％.其中同胞人类白细胞抗原(HLA)全相合及亲缘HLA单倍型相合造血于细胞移植的患者3年OS率分别为56％和60％,3年LFS率为45％和54％.两组在OS时间及LFS时间方面的差异均元统计学意义(x2=0.074,P=0.786;x2=0.006,P=0.941).47例(87.0％)患者移植前本病处于首次完全缓解(CR1),7例(13.0％)患者移植前本病处于非CR1期.处于CR1期的患者的生存显著优于非CR1期患者.结论 allo-HSCT是FLT3-ITD阳性AML患者的有效治疗方法,亲缘HLA单倍型相合造血干细胞移植与同胞HLA全相合移植疗效相似.疾病复发是影响其疗效的主要因素.
목적 분석이기인조혈간세포이식(allo-HSCT)치료반유Fms양락안산격매3기인내부천련중복(FLT3-ITD)양성적급성수성백혈병(AML)적료효,탐토불동이식방식급질병상태대해류환자예후적영향.방법 2006년10월지2012년10월재소주대학부속제일의원행allo-HSCT적AML환자공314례,기중FLT3-ITD양성54례,회고성분석allo-HSCT대FLT3-ITD양성AML환자적림상료효.결과 54례FLT3-ITD양성환자3년총생존(OS)솔위56％,3년무백혈병생존(LFS)솔위47％.기중동포인류백세포항원(HLA)전상합급친연HLA단배형상합조혈우세포이식적환자3년OS솔분별위56％화60％,3년LFS솔위45％화54％.량조재OS시간급LFS시간방면적차이균원통계학의의(x2=0.074,P=0.786;x2=0.006,P=0.941).47례(87.0％)환자이식전본병처우수차완전완해(CR1),7례(13.0％)환자이식전본병처우비CR1기.처우CR1기적환자적생존현저우우비CR1기환자.결론 allo-HSCT시FLT3-ITD양성AML환자적유효치료방법,친연HLA단배형상합조혈간세포이식여동포HLA전상합이식료효상사.질병복발시영향기료효적주요인소.
Objective To study the clinical outcome of patients with fns-like tyrosine kinase-3internal tandem duplication (FLT3-ITD) positive acute myeloid leukemia (AML) treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to explore the potential prognostic factors to patients' survival including transplant types or disease status.Methods A total of 314 AML patients in our center from October 2006 to October 2012 were retrospectively analyzed,among whom,54 patients were defined with FLT3-ITD positive.Survival rates and treatment-related mortality were further analyzed.Results For all 54 FLT3-ITD positive patients,the 3-year overall survival (3-OS) rate was 56％ and 3-year leukemia-free survival (3-LFS) rate was 47％.The outcome of haplo-identical HSCT was similar as that of sibling donors(3-OS rate:60％ vs 54％ ; 3-LFS rate:54％ vs 45％,respectively).There were 47 patients who received transplantation in first complete remission(CR1).The other 7 patients were of disease relapse or in CR2 before transplantation.Not surprisingly,patients in CR1 had better prognosis than those in nonCR1.Conclusions Allo-HSCT is an effective treatment for AML patients with FLT3-ITD positive mutation.The survival outcome of haplo-identical HSCT was comparable with that of sibling donors.Relapse of AML was the dominant factor related to the mortality of FLT3-ITD positive AML patients after allo-HSCT.