發(fā)布時間：2018-03-21 22:40

  本文選題：白血病　切入點：髓樣　出處：《中國組織工程研究》2017年09期 　論文類型：期刊論文

【摘要】：背景:以往研究顯示完全緩解期染色體核型預(yù)后中等的急性髓系白血病患者行親緣全相合異基因外周血造血干細(xì)胞移植有較高的無病生存率和總體生存率,但影響移植預(yù)后的相關(guān)因素并未完全明確。目的:評價HLA相合異基因外周血造血干細(xì)胞移植治療完全緩解期染色體核型預(yù)后中等急性髓系白血病的療效,并對預(yù)后相關(guān)因素進行分析。方法:對2009年1月至2015年1月進行HLA全相合異基因外周血造血干細(xì)胞移植的50例完全緩解期染色體核型預(yù)后中等的急性髓系白血病患者進行回顧性分析,計算總體生存率,并對影響預(yù)后的各因素進行統(tǒng)計學(xué)分析。結(jié)果與結(jié)論:(1)4年總體生存率為64%,累積復(fù)發(fā)率及移植相關(guān)非復(fù)發(fā)死亡率分別為18%及20%。急性移植物抗宿主病的總體發(fā)生率為26%;(2)女性供者男性受者配對移植患者4年總體生存率低于非女性供者男性受者移植患者(P=0.041);移植前大于1個療程才能達(dá)完全緩解的患者4年總體生存率低于移植前1個療程能達(dá)完全緩解的患者(P=0.038);年齡≥40歲的患者4年總體生存率低于年齡40歲的患者(P=0.056);親緣供者移植和非親緣移植患者的4年總體生存率差異無顯著性意義(P=0.427)。女性供者男性受者移植及年齡≥40歲患者移植相關(guān)非復(fù)發(fā)死亡率明顯增高(P值分別為0.024和0.043);(3)多因素分析確認(rèn),與移植預(yù)后相關(guān)的因素有:女性供者男性受者配對移植(P=0.031,RR=1.38,95%CI 1.03-1.95)、移植前大于1個療程才能達(dá)完全緩解(P=0.016,RR=1.46,95%CI 1.10-1.98)、年齡≥40歲(P=0.024,RR=1.63,95%CI 1.32-2.12);(4)結(jié)果表明,HLA全相合異基因外周血造血干細(xì)胞移植是染色體核型預(yù)后中等急性髓系白血病緩解后治療的有效方法。女性供者男性受者配對移植、移植前大于1個療程才能達(dá)完全緩解、年齡≥40歲是影響這類患者預(yù)后的主要危險因素。這類患者行異基因外周血造血干細(xì)胞移植時,供者受者的性別組合比是否為親緣供者更為重要。
[Abstract]:Background: previous studies have shown that patients with moderate chromosome karyotype in complete remission stage of acute myeloid leukemia receiving allogeneic allogeneic peripheral blood stem cell transplantation have higher disease-free survival rate and overall survival rate. Objective: to evaluate the effect of allogeneic peripheral blood stem cell transplantation (PBSCT) on the prognosis of moderate acute myeloid leukemia (MARL) in complete remission stage. Methods: from January 2009 to January 2015, 50 patients with HLA allogeneic peripheral blood stem cell transplantation (PBSCT) with moderate prognosis of chromosome karyotype in complete remission stage were analyzed. The patients were analyzed retrospectively. To calculate the overall survival rate, Results and conclusions the overall 4 year survival rate was 64%, cumulative recurrence rate and transplant related non-recurrent mortality were 18% and 20% respectively. The overall incidence of acute graft-versus-host disease was 20%. The overall 4 year survival rate of female donors and male recipients was lower than that of non-female male recipients, and the overall 4 year survival rate of patients with complete remission before transplantation was lower than that of patients with complete remission before transplantation. The 4-year overall survival rate of the patients aged more than 40 years was lower than that of the patients aged 40 years. There was no significant difference in the 4-year overall survival rate between the patients with relative donor transplantation and those with unrelated transplantation. The mortality of male recipients and patients aged 鈮，

本文編號：1645915