Bondarenko S N, Semenova E V, Vavilov V N, Stancheva N V, Morozova E V, Alianskiĭ A L, Babenko E V, Osipova N É, Zubarovskaia L S, Afanas'ev B V
Ter Arkh. 2013;85(7):18-25.
AIM: To evaluate the efficiency of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with acute myeloblastic leukemia in first remission depending on the regimens of conditioning, the source of a graft, and the characteristics of a donor and a recipient. SUBJECTS AND METHODS: In 66 treated patients, including from partially HLA-mismatched relatives (n=4), the efficiency of allo-HSCT from related donors (n=26) and unrelated donors (n=40), were compared. According to cytogenetic findings, 7 (11%), 31 (47%), and 10 (15%) patients belonged to low-, intermediate-, and high-risk groups, respectively. RESULTS: Five-year overall survival (OS) and mortality associated with transplantation were 56 and 22% for allo-HSCT from related donors, 68 and 23% for that from HLA-matched donors, and 71 and 25% for that from partially HLA-mismatched donors, respectively (p=0.8 and p=0.7). The relapse risk after allo-HSCT from unrelated donors was significantly lower than after that from related donors (13 and 35%, respectively; p=0.8). Univariate analysis showed that the OS rates depended on the cytogenetic risk group (OS was 24 and 64% in the high- and intermediate-risk groups, respectively (p=0.027). The relapse risk in chronic graft-versus-host reaction (GVHR) and in grade 3 acute GVHR (p=0.01) was shown to be less than that in grades 1-2 acute GVHR (p=0.06). CONCLUSION: OS rates after allo-HSCT from related and unrelated donors were comparable and unrelated to the source of a graft, the regimen of conditioning, and other characteristics of a donor and a recipient.
目的:根据预处理方案、移植物来源以及供受者特征,评估首次缓解的急性髓细胞白血病患者接受异基因造血干细胞移植(allo-HSCT)的疗效。 对象与方法:比较66例接受治疗的患者,包括来自部分HLA配型不合亲属(n = 4)、相关供者(n = 26)和无关供者(n = 40)的allo-HSCT疗效。根据细胞遗传学结果,7例(11%)、31例(47%)和10例(15%)患者分别属于低、中、高危组。 结果:相关供者allo-HSCT的5年总生存率(OS)和移植相关死亡率分别为56%和22%,HLA配型相合供者的分别为68%和23%,部分HLA配型不合供者的分别为71%和25%(p = 0.8和p = 0.7)。无关供者allo-HSCT后的复发风险显著低于相关供者(分别为13%和35%;p = 0.8)。单因素分析显示,OS率取决于细胞遗传学风险组(高危组和中危组的OS分别为24%和64%(p = 0.027))。慢性移植物抗宿主病(GVHR)和3级急性GVHR的复发风险(p = 0.01)低于1 - 2级急性GVHR(p = 0.06)。 结论:相关和无关供者allo-HSCT后的OS率相当,且与移植物来源、预处理方案以及供受者的其他特征无关。
Nan Fang Yi Ke Da Xue Xue Bao. 2011-3
Biol Blood Marrow Transplant. 2011-11-10