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[自体外周血干细胞移植与骨髓移植治疗急性白血病的疗效比较]

[Comparison of curative effect of autologous peripheral blood stem cell transplantation versus bone marrow transplantation for acute leukemia].

作者信息

Zhang Yi-Zhuo, Zhang Bo-Long, Yao Shan-Qian, Liu Hai-Chuan, Lou Fang-Ding, Gao Chun-Ji, Han Xiao-Ping, Wu Xiao-Xiong, Zhao Yu, Wang Quan-Shun, Jing Yu, Zhang Miao, Jin Hai-Jie, Shi Zi-Jiang, Da Wan-Ming

机构信息

Department of Hematology, General Hospital of Chinese PLA, Beijing 100853.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2003 Feb;11(1):81-5.

Abstract

To compare the clinical outcome of autologous peripheral blood stem cell transplantation (APBSCT) and autologous bone marrow transplantation (ABMT) in treatment of patients with acute leukemia in first remission, 41 patients received APBSCT, 17 patients received unpurged ABMT and 30 patients received purged ABMT. The results showed that hematopoietic recovery was significantly earlier after APBSCT than that after purged or unpurged ABMT. The 3-year disease-free survival (DFS), relapse rate (RR) and transplant-related mortality (TRM) for all patients of 3 groups were 51.7%, 41.7% and 6.8%, respectively. DFS and RR were significantly influenced by disease types (ALL or AML) and intervals between diagnosis and CR(1) or CR(1) and transplant. The main causes of transplant-related death were infection and hemorrhage. After APBSCT, DFS, RR and TRM were 48.4%, 43.9% and 4.9%, respectively, and did not differ significantly from those found in unpurged ABMT (47.1%, 45.6% and 11.8%) or purged ABMT (66.5%, 29.6% and 6.7%). It is concluded that the clinical outcome of APBSCT is similar to unpurged or purged ABMT but APBSCT allows faster recovery of hematopoiesis and needs less transfusion support.

摘要

为比较自体外周血干细胞移植(APBSCT)和自体骨髓移植(ABMT)治疗首次缓解期急性白血病患者的临床疗效,41例患者接受了APBSCT,17例患者接受了未净化的ABMT,30例患者接受了净化的ABMT。结果显示,APBSCT后造血恢复明显早于净化或未净化的ABMT。三组所有患者的3年无病生存率(DFS)、复发率(RR)和移植相关死亡率(TRM)分别为51.7%、41.7%和6.8%。DFS和RR受疾病类型(ALL或AML)以及诊断与CR(1)或CR(1)与移植之间的间隔时间显著影响。移植相关死亡的主要原因是感染和出血。APBSCT后,DFS、RR和TRM分别为48.4%、43.9%和4.9%,与未净化的ABMT(47.1%、45.6%和11.8%)或净化的ABMT(66.5%、29.6%和6.7%)相比,差异无统计学意义。结论是,APBSCT的临床疗效与未净化或净化的ABMT相似,但APBSCT可使造血恢复更快,且所需输血支持更少。

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