中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2014年
11期
689-692
,共4页
桂晓敏%仇惠英%潘金兰%周敏%鲍协炳%陈苏宁%孙爱宁%吴德沛%岑建农
桂曉敏%仇惠英%潘金蘭%週敏%鮑協炳%陳囌寧%孫愛寧%吳德沛%岑建農
계효민%구혜영%반금란%주민%포협병%진소저%손애저%오덕패%잠건농
T315I%白血病%异基因造血干细胞移植%复发
T315I%白血病%異基因造血榦細胞移植%複髮
T315I%백혈병%이기인조혈간세포이식%복발
T315I%Leukemia%Allogeneic stem cell transplantation%Recurrence
目的 分析BCR-ABL融合基因T315I突变的白血病患者接受异基因造血干细胞移植(HSCT)的资料,探讨移植疗效及复发后的治疗.方法 观察10例伴T315I突变的费城染色体阳性(Ph+)的急性淋巴细胞白血病(ALL)和慢性粒细胞白血病(CML)接受异基因HSCT后缓解率、复发率以及长期存活情况,分析这类受者的移植疗效.结果 10例受者中,男性6例,女性4例,中位年龄29岁(18~49岁),原发病为CML 3例及Ph+ ALL 7例.T315I突变前服用伊马替尼5例,尼洛替尼3例,以及达沙替尼2例;10例(100%)受者在移植后均获得骨髓缓解,缓解的中位时间为23 d(14~56)d.至随访截止,4例(40%)受者存活(包括1例CML和3例Ph+ ALL)存活,目前均处于完全缓解状态(CR),存活时间为75~741 d.余6例(60%)死亡,1例于移植后137 d死于消化道出血,2例于移植后53 d和617 d死于移植物抗宿主病(GVHD),3例受者(包括1例CML和2例Ph+ALL受者)分别于移植后27、50和130 d出现白血病复发,其中2例在复发后5d和40 d死亡,1例复发后行化疗未缓解,于复发后97 d死亡.结论 伴T315I突变的Ph+ ALL和CML行异基因HSCT可以获得较高的缓解率,但同时存在较高的复发风险;白血病复发的受者可以进一步采取相关治疗争取延长存活时间.
目的 分析BCR-ABL融閤基因T315I突變的白血病患者接受異基因造血榦細胞移植(HSCT)的資料,探討移植療效及複髮後的治療.方法 觀察10例伴T315I突變的費城染色體暘性(Ph+)的急性淋巴細胞白血病(ALL)和慢性粒細胞白血病(CML)接受異基因HSCT後緩解率、複髮率以及長期存活情況,分析這類受者的移植療效.結果 10例受者中,男性6例,女性4例,中位年齡29歲(18~49歲),原髮病為CML 3例及Ph+ ALL 7例.T315I突變前服用伊馬替尼5例,尼洛替尼3例,以及達沙替尼2例;10例(100%)受者在移植後均穫得骨髓緩解,緩解的中位時間為23 d(14~56)d.至隨訪截止,4例(40%)受者存活(包括1例CML和3例Ph+ ALL)存活,目前均處于完全緩解狀態(CR),存活時間為75~741 d.餘6例(60%)死亡,1例于移植後137 d死于消化道齣血,2例于移植後53 d和617 d死于移植物抗宿主病(GVHD),3例受者(包括1例CML和2例Ph+ALL受者)分彆于移植後27、50和130 d齣現白血病複髮,其中2例在複髮後5d和40 d死亡,1例複髮後行化療未緩解,于複髮後97 d死亡.結論 伴T315I突變的Ph+ ALL和CML行異基因HSCT可以穫得較高的緩解率,但同時存在較高的複髮風險;白血病複髮的受者可以進一步採取相關治療爭取延長存活時間.
목적 분석BCR-ABL융합기인T315I돌변적백혈병환자접수이기인조혈간세포이식(HSCT)적자료,탐토이식료효급복발후적치료.방법 관찰10례반T315I돌변적비성염색체양성(Ph+)적급성림파세포백혈병(ALL)화만성립세포백혈병(CML)접수이기인HSCT후완해솔、복발솔이급장기존활정황,분석저류수자적이식료효.결과 10례수자중,남성6례,녀성4례,중위년령29세(18~49세),원발병위CML 3례급Ph+ ALL 7례.T315I돌변전복용이마체니5례,니락체니3례,이급체사체니2례;10례(100%)수자재이식후균획득골수완해,완해적중위시간위23 d(14~56)d.지수방절지,4례(40%)수자존활(포괄1례CML화3례Ph+ ALL)존활,목전균처우완전완해상태(CR),존활시간위75~741 d.여6례(60%)사망,1례우이식후137 d사우소화도출혈,2례우이식후53 d화617 d사우이식물항숙주병(GVHD),3례수자(포괄1례CML화2례Ph+ALL수자)분별우이식후27、50화130 d출현백혈병복발,기중2례재복발후5d화40 d사망,1례복발후행화료미완해,우복발후97 d사망.결론 반T315I돌변적Ph+ ALL화CML행이기인HSCT가이획득교고적완해솔,단동시존재교고적복발풍험;백혈병복발적수자가이진일보채취상관치료쟁취연장존활시간.
Objective To retrospectively analyze the curative effectiveness of allogeneic stem cell transplantation (allo-SCT) for the leukemia patients with the T315I mutation,and to discuss the treatments for the relapsing patients after allo-SCT.Method Through observing 10 leukemia patients harboring a T315I BCR-ABL mutation who underwent allo-SCT,we analyzed the remission rate,recurrence rate and long-term survival situation of these patients and explored the treatments for relapsing patients after allo-SCT.Result Of 10 patients,4 patients were female and 6 were male.The median age was 29 years (range,18-49).Before HSCT,5 were given imatinib,3 nilotinib and 2 dasatinib,respectively.Ten patients (100%) obtained complete remission (CR) and the median remission time was 23 days (range,14-56).During the follow-up period,1 case of CML and 3 cases of Ph+-ALL (40%) obtained CR.The survival time was 75 to 741 days.In the 6 dead patients,1 died of upper gastrointestinal hemorrhage on the day 137 after allo-SCT; 2 died of graft versus host disease on the day 53 and 617 respectively after allo-SCT; 1 case of CML and 2 cases of Ph+ ALL relapsed on the day 27,50 and 130 respectively after allo-SCT,and 2 of them died on the day 5 and 40 respectively after relapse,and 1 recurrent case did not obtain remission after chemotherapy and died on the day 97 after relapse.Conclusion The allo-SCT can be used to treat the leukemia patients with T315I mutation,and high remission rate can be obtained,tut there is the high risk of recurrence.The patients with recurrent leukemia can take further relevant treatment to prolong survival time.