Stem Cell Transplantation Center, Hokkaido University Hospital, Sapporo 060-8648, Japan.
Int J Hematol. 2010 Mar;91(2):310-21. doi: 10.1007/s12185-009-0487-y. Epub 2010 Jan 20.
Acute myelogenous leukemia (AML) with favorable cytogenetics responds well to chemotherapy. If the leukemia relapses, allogenic hematopoietic stem transplantation (allo-HSCT) is considered as a treatment option. Since the efficacy of reduced-intensity stem cell transplantation (RIST) for AML with favorable cytogenetics has not been established, we retrospectively analyzed the outcomes of allo-HSCT in AML patients according to cytogenetic risks. The outcome of allo-HSCT for AML patients with favorable cytogenetics seemed to be superior to that for AML patients with intermediate cytogenetics. In AML patients with favorable cytogenetics, the 3-year overall survival (OS) and relapse-free survival (RFS) rates were 88 and 76%, respectively, in the RIST group. Both the 3-year OS and RFS rates were 81% in the conventional stem cell transplantation (CST) group. The outcome of RIST for AML patients with favorable cytogenetics was comparable to that for patients who received CST despite the more advanced age and greater organ dysfunction in RIST group than in CST group. None of the patients died within 90 days after RIST. Moreover, there was no relapse in patients with favorable cytogenetics who were in hematological remission prior to RIST. Thus, RIST for AML patients with favorable cytogenetics in remission is safe and effective.
伴有利细胞遗传学的急性髓系白血病（AML）对化疗反应良好。如果白血病复发，异体造血干细胞移植（allo-HSCT）被认为是一种治疗选择。由于低强度干细胞移植（RIST）对伴有利细胞遗传学的 AML 的疗效尚未确定，我们根据细胞遗传学风险回顾性分析了伴有利细胞遗传学的 AML 患者 allo-HSCT 的结果。伴有利细胞遗传学的 AML 患者的 allo-HSCT 结果似乎优于伴中等细胞遗传学的 AML 患者。在伴有利细胞遗传学的 AML 患者中，RIST 组的 3 年总生存率（OS）和无复发生存率（RFS）分别为 88%和 76%。CST 组的 3 年 OS 和 RFS 率分别为 81%。尽管 RIST 组比 CST 组年龄更大，器官功能障碍更严重，但伴有利细胞遗传学的 AML 患者接受 RIST 的结果与接受 CST 的患者相当。RIST 后 90 天内无患者死亡。此外，在 RIST 前处于血液学缓解的伴有利细胞遗传学患者中无复发。因此，缓解期伴有利细胞遗传学的 AML 患者进行 RIST 是安全有效的。
