Fei Q, Huang X J, Liu Y, Xu L P, Zhang X H, Liu K Y, Chen H, Chen Y Y, Wang Y
Hematology Department of Peking University people's Hospital, Institute of Hematology of Peking University people's Hospital, Beijing 100044, China.
Zhonghua Xue Ye Xue Za Zhi. 2018 Jul 14;39(7):546-551. doi: 10.3760/cma.j.issn.0253-2727.2018.07.004.
To investigate the prognosis of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in the treatment of acute myeloid leukemia with myelodysplasia-related changes (AML-MRC). The data of 102 patients with high-risk AML in the first complete remission phase (CR1) who received haplo-HSCT from January 2009 to July 2015 in Peking University People's Hospital were retrospectively analyzed. These 102 cases included 17 AML-MRC cases (AML-MRC group) and 85 other types of AML cases (control group). There were 8 males and 9 females in the AML-MRC group, and the median age was 35 (17-61) years. There were 52 males and 33 females in other high-risk AML group, and the median age was 31 (11-60) years. No difference was observed between the two groups after haploidentical stem cell transplantation in the rates of cytomegalovirus, EBV (Epstein-Barr virus), blood flow infection rate and hematopoietic reconstitution (>0.05). The overall 2-year survival rate after transplantation was 80.8% (95% 51.6%-93.4%) and 72.5% (95% 62.8%-80.1%) (=0.650), the disease-free survival rate was 79.4% (95% 48.8%-92.9%) and 65.9% (95% 54.3%-75.2%) (=0.573), cumulative recurrence rate was 13.0%(95% 1.9%-34.7%) and 13.3%(95% 7.0%-21.5%) (=0.623), and non-relapse mortality was 6.7% (95% 0.3%-27.0%) and 20.0% (95% 12.0%-29.4%) (=0.436). The prognosis of haplo-HSCT in patients with AML-MRC in CR(1) is similar to that of other types of high-risk AML patients. Haplo-HSCT is an ideal choice for patients with AML-MRC in CR(1).
探讨单倍型造血干细胞移植(haplo-HSCT)治疗伴有骨髓增生异常相关改变的急性髓系白血病(AML-MRC)的预后。回顾性分析2009年1月至2015年7月在北京大学人民医院接受haplo-HSCT的102例处于首次完全缓解期(CR1)的高危AML患者的数据。这102例患者中包括17例AML-MRC患者(AML-MRC组)和85例其他类型AML患者(对照组)。AML-MRC组中男性8例,女性9例,中位年龄为35(17 - 61)岁。其他高危AML组中男性52例,女性33例,中位年龄为31(11 - 60)岁。单倍型干细胞移植后,两组在巨细胞病毒、EB病毒(Epstein-Barr病毒)感染率、血流感染率及造血重建方面差异均无统计学意义(>0.05)。移植后总体2年生存率分别为80.8%(95% 51.6% - 93.4%)和72.5%(95% 62.8% - 80.1%)(P = 0.650),无病生存率分别为79.4%(95% 48.8% - 92.9%)和65.9%(95% 54.3% - 75.2%)(P = 0.573),累积复发率分别为13.0%(95% 1.9% - 34.7%)和13.3%(95% 7.0% - 21.5%)(P = 0.623),非复发死亡率分别为6.7%(95% 0.3% - 27.0%)和20.0%(95% 12.0% - 29.4%)(P = 0.436)。处于CR(Ⅰ)期的AML-MRC患者接受haplo-HSCT的预后与其他类型高危AML患者相似。Haplo-HSCT是CR(Ⅰ)期AML-MRC患者的理想选择。