Jantunen E, Itälä M, Siitonen T, Juvonen E, Koivunen E, Koistinen P, Volin L, Remes K, Nousiainen T
Department of Medicine, Kuopio University Hospital, 70211 Kuopio, Finland.
Bone Marrow Transplant. 2006 Jun;37(12):1093-8. doi: 10.1038/sj.bmt.1705375. Epub 2006 May 8.
Although autologous stem cell transplantation (ASCT) has gained some popularity as a treatment option in patients with chronic lymphocytic leukaemia (CLL), limited multicentre data are available on the feasibility and efficacy of this approach. Between January 1995 and June 2005, 72 patients with CLL received ASCT in five Finnish centres. There were 45 men and 27 women with a median age of 57 years (38-69). The median time from diagnosis to ASCT was 32 months (6-181) and the median number of prior regimens 1 (1-4). All patients received blood stem cell grafts and CD34+ selection had been performed in 44 patients (61%). The most common high-dose regimen was a total body irradiation plus cyclophosphamide (38 patients, 53%). No early treatment-related deaths were observed. With a median follow-up of 28 months from ASCT, a relapse or progression has been observed in 27 patients (37%). The projected progression-free survival is 48 months (confidence interval (CI) 30-66). The projected median overall survival is 95 months (CI 74-101) from ASCT and is not influenced by graft selection or conditioning regimen used. Autologous stem cell transplantation is a feasible treatment option for CLL. Randomized trials against alternative treatments are needed to assess the impact of ASCT on the clinical course of CLL.
尽管自体干细胞移植（ASCT）作为慢性淋巴细胞白血病（CLL）患者的一种治疗选择已受到一定程度的欢迎，但关于该方法的可行性和疗效的多中心数据有限。1995年1月至2005年6月期间，72例CLL患者在芬兰的五个中心接受了ASCT。其中男性45例，女性27例，中位年龄57岁（38 - 69岁）。从诊断到ASCT的中位时间为32个月（6 - 181个月），既往治疗方案的中位数量为1个（1 - 4个）。所有患者均接受了造血干细胞移植，44例患者（61%）进行了CD34+细胞分选。最常用的大剂量方案是全身照射加环磷酰胺（38例患者，53%）。未观察到早期治疗相关死亡。自ASCT起中位随访28个月，27例患者（37%）出现复发或病情进展。预计无进展生存期为48个月（置信区间（CI）30 - 66）。自ASCT起预计中位总生存期为95个月（CI 74 - 101），且不受所采用的移植物选择或预处理方案的影响。自体干细胞移植是CLL的一种可行治疗选择。需要针对替代治疗的随机试验来评估ASCT对CLL临床病程的影响。
