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两种预处理方案在异基因造血干细胞移植治疗白血病中的比较

[Comparison of two conditioning regimens in treatment of leukemia by allogeneic hematopoietic stem cell transplantation].

作者信息

Zhang Guo-Cai, Zheng Dong, Guan Xun-Xing, Luo Shao-Kai, Li Juan, Peng Ai-Hua, Tong Xiu-Zhen, Lai Feng-Zhen, Tan En-Xun, Hong Wen-De

机构信息

Department of Hematology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, PR China.

出版信息

Ai Zheng. 2003 Jun;22(6):620-3.

Abstract

BACKGROUND & OBJECTIVE: The conditioning regimens are the critical factors in the allogeneic hematopoietic stem cell transplantation. This study was conducted to compare the effectiveness and side-effects of two conditioning regimens in allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODS

Twenty-one cases received busulfan(BU) 16 mg/kg plus cyclophosphamide(CY) 120 mg/kg,the other 23 cases received total body irradiation(TBI) 7.5-8.5 Gy plus CY 120 mg/kg regimen.

RESULTS

The 3-year disease-free survivals (DFS) were 61.5% in BU/CY group and 64.7% in TBI/CY group, respectively (P >0.05). The relapse rates were 23.8% and 26%, respectively, without significant difference (P >0.05). The incidence of liver damage in the BU/CY group was higher (80.9%) than that in the TBI/CY group (54.3%) (P< 0.05), while no case developed hepatic veno-occlusive disease. Stomatitis and gastrointestinal toxicity were significantly lower in the BU/CY group (33.3% and 42.9%) compared with TBI/CY group (78.2% and 78.2%), respectively (P< 0.05). Bladder toxicity (23.8% and 26%) and pulmonary toxicity(14.3% and 13%) were similar in the two groups(P >0.05), while one patient in TBI/CY group developed grade IV pulmonary toxicity, which is lethal. No case was found to have cardiac, renal, or central nervous system grade I toxicity.

CONCLUSION

The two groups have equal effectiveness, BU/CY regimen is relatively easy to administer and well tolerated with low extramedullary toxicity.

摘要

背景与目的

预处理方案是异基因造血干细胞移植中的关键因素。本研究旨在比较两种预处理方案在异基因造血干细胞移植(allo-HSCT)中的有效性和副作用。

方法

21例患者接受白消安(BU)16mg/kg加环磷酰胺(CY)120mg/kg方案,另外23例患者接受全身照射(TBI)7.5 - 8.5Gy加CY 120mg/kg方案。

结果

BU/CY组和TBI/CY组的3年无病生存率(DFS)分别为61.5%和64.7%(P>0.05)。复发率分别为23.8%和26%,无显著差异(P>0.05)。BU/CY组肝损伤发生率(80.9%)高于TBI/CY组(54.3%)(P<0.05),但两组均未发生肝静脉闭塞病。与TBI/CY组(分别为78.2%和78.2%)相比,BU/CY组口腔炎和胃肠道毒性显著更低(分别为33.3%和42.9%)(P<0.05)。两组膀胱毒性(23.8%和26%)和肺部毒性(14.3%和13%)相似(P>0.05),但TBI/CY组有1例患者发生IV级肺部毒性,为致死性。未发现有心脏、肾脏或中枢神经系统I级毒性的病例。

结论

两组疗效相当,BU/CY方案给药相对简便,耐受性良好,髓外毒性低。

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