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异基因造血干细胞移植后儿童急性髓系白血病供者类型或干细胞来源的生存结局比较:岭南儿科血液肿瘤学研究联盟的多中心回顾性研究

Comparison of survival outcome between donor types or stem cell sources for childhood acute myeloid leukemia after allogenic hematopoietic stem cell transplantation: A multicenter retrospective study of Study Alliance of Yeungnam Pediatric Hematology-oncology.

作者信息

Shim Ye Jee, Lee Jae Min, Kim Heung Sik, Jung Nani, Lim Young Tak, Yang Eu Jeen, Hah Jeong Ok, Lee Young-Ho, Chueh Hee Won, Lim Jae Young, Park Eun Sil, Park Jeong A, Park Ji Kyoung, Park Sang Kyu

机构信息

Department of Pediatrics, Keimyung University School of Medicine and Dongsan Medical Center, Daegu, Korea.

Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea.

出版信息

Pediatr Transplant. 2018 Jun 19:e13249. doi: 10.1111/petr.13249.

Abstract

We compared transplant outcomes between donor types and stem cell sources for childhood acute myeloid leukemia (AML). The medical records of children with AML in the Yeungnam region of Korea from January 2000 to June 2017 were reviewed. In all, 76 children with AML (male-to-female ratio = 46:30) received allogenic hematopoietic stem cell transplantation (allo-HSCT). In total, 29 patients received HSCT from either a matched-related donor or a mismatched-related donor, 32 patients received an unrelated donor, and 15 patients received umbilical cord blood. In term of stem cell sources, bone marrow was used in 15 patients and peripheral blood in 46 patients. For all HSCT cases, the 5-year overall survival (OS) was 73.1% (95% CI: 62.7-83.5) and the 5-year event-free survival (EFS) was 66.1% (95% CI: 54.5-77.7). There was no statistical difference in 5-year OS according to the donor types or stem cell sources (P = .869 and P = .911). There was no statistical difference in 5-year EFS between donor types or stem cell sources (P = .526 and P = .478). For all HSCT cases, the 5-year relapse rate was 16.1% (95% CI: 7.3-24.9) and the 5-year non-relapse mortality (NRM) was 13.3% (95% CI: 5.1-21.5). There was no statistical difference in the 5-year relapse rate according to the donor types or stem cell sources (P = .971 and P = .965). There was no statistical difference in the 5-year NRM between donor types or stem cell sources (P = .461 and P = .470).

摘要

我们比较了儿童急性髓系白血病(AML)不同供体类型和干细胞来源的移植结局。回顾了2000年1月至2017年6月韩国岭南地区AML患儿的病历。共有76例AML患儿(男女比例为46:30)接受了异基因造血干细胞移植(allo-HSCT)。其中,29例患者接受了来自匹配相关供体或不匹配相关供体的HSCT,32例患者接受了无关供体的移植,15例患者接受了脐带血移植。在干细胞来源方面,15例患者使用了骨髓,46例患者使用了外周血。对于所有HSCT病例,5年总生存率(OS)为73.1%(95%CI:62.7-83.5),5年无事件生存率(EFS)为66.1%(95%CI:54.5-77.7)。根据供体类型或干细胞来源,5年OS无统计学差异(P = 0.869和P = 0.911)。供体类型或干细胞来源之间的5年EFS无统计学差异(P = 0.526和P = 0.478)。对于所有HSCT病例,5年复发率为16.1%(95%CI:7.3-24.9),5年非复发死亡率(NRM)为13.3%(95%CI:5.1-21.5)。根据供体类型或干细胞来源,5年复发率无统计学差异(P = 0.971和P = 0.965)。供体类型或干细胞来源之间的5年NRM无统计学差异(P = 0.461和P = 0.470)。

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