摘要
目的探讨含去甲氧柔红霉素(IDA)的预处理方案在异基因造血干细胞移植(allo-HSCT)治疗高危难治性白血病中的临床疗效。方法对116例接受了allo-HSCT的高危难治性白血病患者,采用7种含IDA的预处理方案。总结116例受者的植入情况。采用Kaplan-Meier曲线对2年总生存率(OS)、2年无病生存率(DFS)、累积复发率、复发病死率、移植相关病死率(TRM)、急性移植物抗宿主疾病(aGVHD)及慢性移植物抗宿主疾病(cGVHD)的累积发生率进行统计学分析。结果116例受者均成功植入。中位随访时间为28(7~70)个月,64例受者存活,2年OS为55.2%,2年DFS为51.7%,2年复发病死率23.3%,2年TRM为18.1%。116例受者中有72例发生aGVHD,aGVHD 2年累积发生率为62.1%,其中Ⅲ~Ⅳ度aGVHD 20例,2年累积发生率为17.2%。59例发生cGVHD,2年累积发生率为55.4%,其中广泛型cGVHD 2年累积发生率为14.7%。116例受者中有30例复发,2年累积复发率为25.9%。结论含IDA的预处理方案安全性和有效性均较高,可以作为高危难治性白血病患者移植预处理的有效方案。
Objective To investigate the clinical efficacy of pretreatment regimen containing idarubicin(IDA)in allogeneic hematopoietic stem cell transplantation(allo-HSCT)for high-risk refractory leukemia.Methods A total of 116 patients with high-risk refractory leukemia who received allo-HSCT treated with 7 types of IDA-containing pretreatment regimes were enrolled in this study.The implantation rate of 116 recipients was summed up.The 2-year overall survival(OS),2-year disease free survival(DFS),cumulative recurrence rate,recurrent mortality,transplantation related mortality(TRM),cumulative incidence of acute graft-versus-host disease(aGVHD)and chronic graft-versus-host disease(cGVHD)were statistically analyzed by Kaplan-Meier survival curve.Results All 116 recipients successfully implanted.The median follow-up time was 28(7-70)months.Among them,64 recipients survived,the 2-year OS was 55.2%,2-year DFS was 51.7%,2-year recurrent mortality was 23.3%and 2-year TRM was 18.1%.Among 116 recipients,72 cases suffered from aGVHD.The 2-year cumulative incidence rate of aGVHD was 62.1%including 20 cases of gradeⅢ-ⅣaGVHD,the 2-year cumulative incidence rate was 17.2%.Among 116 recipients,59 cases presented with cGVHD.The 2-year cumulative incidence rate was 55.4%,of which the 2-year cumulative incidence rate of extensive cGVHD was 14.7%.Among 116 recipients,30 cases recurred with a 2-year cumulative recurrence rate of 25.9%.Conclusions IDA-containing pretreatment regime has high safety and effectiveness,and can be used as an effective pretreatment regime for transplantation preprocessing in patients with high-risk refractory leukemia.
作者
程昊钰
杨怡欣
杨帆
张维婕
费新红
殷宇明
顾江英
满其航
赵杰
王静波
Cheng Haoyu;Yang Yixin;Yang Fan;Zhang Weijie;Fei Xinhong;Yin Yuming;Gu Jiangying;Man Qihang;Zhao Jie;Wang Jingbo(Department of Hematology,Aerospace Center Hospital,Beijing 100049,China)
出处
《器官移植》
CAS
CSCD
北大核心
2020年第2期240-246,共7页
Organ Transplantation
关键词
去甲氧柔红霉素
高危难治性白血病
急性髓系白血病
急性淋巴细胞白血病
预处理
异基因造血干细胞移植
复发
总生存率
无病生存率
累积复发率
Idarubicin
High-risk refractory leukemia
Acute myeloid leukemia
Acute lymphoblastic leukemia
Pretreatment
Allogeneic hematopoietic stem cell transplantation
Recurrence
Overall survival
Disease free survival
Cumulative recurrence rate
