中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2014年
2期
129-133
,共5页
余晓%李彩霞%吴小津%叶璐%刘红%马超%马金凤%顾彩红%吴德沛
餘曉%李綵霞%吳小津%葉璐%劉紅%馬超%馬金鳳%顧綵紅%吳德沛
여효%리채하%오소진%협로%류홍%마초%마금봉%고채홍%오덕패
二代酪氨酸激酶抑制剂%造血干细胞移植%白血病%费城染色体
二代酪氨痠激酶抑製劑%造血榦細胞移植%白血病%費城染色體
이대락안산격매억제제%조혈간세포이식%백혈병%비성염색체
Second-generation tyrosine kinase inhibitors%Hematopoietic stem cell transplantation%Leukemia%Philadelphia chromosome
目的 探讨二代酪氨酸激酶抑制剂(TK-Ⅱ)联合异基因造血干细胞移植(allo-HSCT)治疗高危Ph染色体阳性(Ph+)白血病的疗效及安全性.方法 对17例行allo-HSCT的高危Ph+白血病患者进行回顾性分析,其中慢性髓性白血病(CML)8例(加速期1例、急变期7例),Ph+急性淋巴细胞白血病(Ph+ALL)9例.在allo-HSCT前后给予尼洛替尼或达沙替尼治疗,观察疗效及不良反应.结果 所有患者均成功植入,粒系重建的中位时间为12(10～14)d,巨核系重建的中位时间为15(11～23)d.7例患者发生急性移植物抗宿主病(GVHD),其中Ⅰ～Ⅱ度6例,Ⅲ度1例；6例发生慢性GVHD,均为局限型；无致死性GVHD发生.17例患者中位随访时间为17(3～60)个月,11例无病生存,6例复发,其中5例死亡.结论 TK-Ⅱ联合allo-HSCT可有效提高高危Ph+白血病患者的缓解率,减少allo-HSCT后复发,从而有助于提高高危ph+白血病的治疗成功率.
目的 探討二代酪氨痠激酶抑製劑(TK-Ⅱ)聯閤異基因造血榦細胞移植(allo-HSCT)治療高危Ph染色體暘性(Ph+)白血病的療效及安全性.方法 對17例行allo-HSCT的高危Ph+白血病患者進行迴顧性分析,其中慢性髓性白血病(CML)8例(加速期1例、急變期7例),Ph+急性淋巴細胞白血病(Ph+ALL)9例.在allo-HSCT前後給予尼洛替尼或達沙替尼治療,觀察療效及不良反應.結果 所有患者均成功植入,粒繫重建的中位時間為12(10～14)d,巨覈繫重建的中位時間為15(11～23)d.7例患者髮生急性移植物抗宿主病(GVHD),其中Ⅰ～Ⅱ度6例,Ⅲ度1例；6例髮生慢性GVHD,均為跼限型；無緻死性GVHD髮生.17例患者中位隨訪時間為17(3～60)箇月,11例無病生存,6例複髮,其中5例死亡.結論 TK-Ⅱ聯閤allo-HSCT可有效提高高危Ph+白血病患者的緩解率,減少allo-HSCT後複髮,從而有助于提高高危ph+白血病的治療成功率.
목적 탐토이대락안산격매억제제(TK-Ⅱ)연합이기인조혈간세포이식(allo-HSCT)치료고위Ph염색체양성(Ph+)백혈병적료효급안전성.방법 대17례행allo-HSCT적고위Ph+백혈병환자진행회고성분석,기중만성수성백혈병(CML)8례(가속기1례、급변기7례),Ph+급성림파세포백혈병(Ph+ALL)9례.재allo-HSCT전후급여니락체니혹체사체니치료,관찰료효급불량반응.결과 소유환자균성공식입,립계중건적중위시간위12(10～14)d,거핵계중건적중위시간위15(11～23)d.7례환자발생급성이식물항숙주병(GVHD),기중Ⅰ～Ⅱ도6례,Ⅲ도1례；6례발생만성GVHD,균위국한형；무치사성GVHD발생.17례환자중위수방시간위17(3～60)개월,11례무병생존,6례복발,기중5례사망.결론 TK-Ⅱ연합allo-HSCT가유효제고고위Ph+백혈병환자적완해솔,감소allo-HSCT후복발,종이유조우제고고위ph+백혈병적치료성공솔.
Objective To investigate the efficacy and safety of second-generation tyrosine kinase inhibitors (TK-Ⅱ) combined with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of high-risk Philadelphia chromosome positive (Ph+) leukemia.Methods The clinical data of 17 cases of high-risk Ph+ leukemia patients underwent allo-HSCT were retrospectively analyzed,including 1 case in accelerated phase and 7 cases in blast crises of chronic myeloid leukemia,and 9 cases of Ph+ acute lymphoblastic leukemia.Nilotinib or Dasatinib were aderministrated before and (or) after allo-HSCT in all patients.Results All patients successfully engrafted.Median times to neutrophil and platelet recovery were 12 days (range 10-14) and 15 days (range 11-23),respectively.Acute GVHD developed in 7 patients:6 patient had grade 1 to 2 and 1 patient grade 3.Chronic GVHD developed in 6 patients,all were limited and no lethal GVHD occurred.At a median follow-up of 17 (range 3-60) months,11 (64.7％) patients survived disease free,6 patients relapsed and 5 died.Conclusion TK-Ⅱ combined with allo-HSCT effectively improved the remission rate of high-risk Ph+ leukemia and reduced recurrence after allo-HSCT,which represented an important improvement in the treatment of patients with high-risk Ph + leukemia.
