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HLA 不合型造血干细胞微移植与同胞相合供者移植治疗中高危急性髓系白血病的比较。

HLA-mismatched stem cell microtransplantation compared to matched-sibling donor transplantation for intermediate/high-risk acute myeloid leukemia.

机构信息

Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People's Republic of China.

Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People's Republic of China.

出版信息

Ann Hematol. 2019 May;98(5):1249-1257. doi: 10.1007/s00277-018-3583-3. Epub 2019 Jan 10.

Abstract

HLA-mismatched stem cell microtransplantation is a new form of transplantation reported in recent years. We compared 59 patients undergoing microtransplantation to 66 patients undergoing HLA-matched sibling donor (MSD) transplantation at the same period from April 2012 to December 2016, who all suffered from intermediate/high-risk acute myelogenous leukemia (AML) in first complete remission (CR1). The estimated overall survival (OS) at 2 years was 74.1% ± 6.2% and 34.3% ± 7.9% in MSD and microtransplantation group, respectively (P = 0.001). The estimated leukemia-free survival (LFS) at 2 years was 73.3% ± 6.1% in the MSD group and 31.6% ± 7.6% in the microtransplantation group (P = 0.000). The 2-year cumulative incidence of relapse was 17.6% and 62.3% in the MSD and microtransplantation groups, respectively (P < 0.0001). The 2-year cumulative incidence of nonrelapse mortality was 10.9% in MSD group and 4.2% in the microtransplantation group (P = 0.251). Hematopoietic recovery time was shorter in the microtransplantation group than in the MSD group (P < 0.05). The infection rate was higher in the MSD group than in the microtransplantation group (P = 0.012). The preliminary results suggested that OS and LFS of microtransplantation were inferior to MSD transplantation for intermediate/high-risk AML in CR1.

摘要

HLA 不合造血干细胞微移植是近年来报道的一种新的移植形式。我们比较了 59 例接受微移植和 66 例同期接受 HLA 匹配同胞供者(MSD)移植的患者,他们均在首次完全缓解(CR1)时患有中/高危急性髓系白血病(AML)。MSD 组和微移植组的 2 年总生存(OS)估计分别为 74.1%±6.2%和 34.3%±7.9%(P=0.001)。MSD 组的 2 年无白血病生存(LFS)估计为 73.3%±6.1%,微移植组为 31.6%±7.6%(P=0.000)。MSD 组和微移植组的 2 年累积复发率分别为 17.6%和 62.3%(P<0.0001)。MSD 组的 2 年非复发死亡率为 10.9%,微移植组为 4.2%(P=0.251)。微移植组的造血恢复时间短于 MSD 组(P<0.05)。MSD 组的感染率高于微移植组(P=0.012)。初步结果表明,对于 CR1 中的中/高危 AML,微移植的 OS 和 LFS 劣于 MSD 移植。

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