采用他克莫司/西罗莫司为基础的移植物抗宿主病预防方案的 MDS 患者的减低强度异基因造血干细胞移植。
Reduced intensity allogeneic hematopoietic stem cell transplantation for MDS using tacrolimus/sirolimus-based GVHD prophylaxis.
机构信息
Department of Hematology/Hematopoietic Cell Transplantation, City of Hope, Duarte, CA 91010, USA.
出版信息
Leuk Res. 2012 Sep;36(9):1152-6. doi: 10.1016/j.leukres.2012.04.022. Epub 2012 Jun 5.
Abstract
We report a consecutive series of 59 patients with MDS who underwent reduced-intensity hematopoietic stem cell transplantation (RI-HSCT) with fludarabine/melphalan conditioning and tacrolimus/sirolimus-based GVHD prophylaxis. Two-year OS, EFS, and relapse incidences were 75.1%, 65.2%, and 20.9%, respectively. The cumulative incidence of non-relapse mortality at 100 days, 1 year, and 2 years was 3.4%, 8.5%, and 10.5%, respectively. The incidence of grade II-IV acute GVHD was 35.4%; grade III-IV was 18.6%. Forty of 55 evaluable patients developed chronic GVHD; of these 35 were extensive grade. This RI-HSCT protocol produces encouraging outcomes in MDS patients, and tacrolimus/sirolimus-based GVHD prophylaxis may contribute to that promising result.
摘要
我们报告了 59 例 MDS 患者连续系列，他们接受了氟达拉滨/马法兰预处理的减低强度造血干细胞移植（RI-HSCT），并采用他克莫司/西罗莫司进行 GVHD 预防。2 年的 OS、EFS 和复发发生率分别为 75.1%、65.2%和 20.9%。100 天、1 年和 2 年的非复发死亡率累积发生率分别为 3.4%、8.5%和 10.5%。Ⅱ-Ⅳ级急性 GVHD 的发生率为 35.4%；Ⅲ-Ⅳ级为 18.6%。55 例可评估患者中有 40 例发生慢性 GVHD；其中 35 例为广泛性。该 RI-HSCT 方案在 MDS 患者中产生了令人鼓舞的结果，而他克莫司/西罗莫司为基础的 GVHD 预防可能促成了这一有希望的结果。
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