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单倍体相合、未处理的粒细胞集落刺激因子(G-CSF)动员外周血干细胞移植治疗缓解期急性髓系白血病(AML):单中心经验

Haploidentical, Unmanipulated Granulocyte Colony-Stimulating Factor (G-CSF)-Primed Peripheral Blood Stem Cell Transplants for Acute Myeloid Leukemia (AML) in Remission: A Single Center Experience.

作者信息

Luo Lan, Fang Shu, Zhao Shasha, Li Fei, Zhou Yu, Guan Lixun, Yang Nan, Gu Zhenyang, Lin Tao, Wang Feiyan, Zhu Chengying, Huang Wenrong, Liu Daihong, Gao Chunji

机构信息

Department of Hematology, Chinese People's Liberation Army (PLA) General Hospital, Medical School of Chinese PLA, Beijing, China (mainland).

Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA.

出版信息

Ann Transplant. 2019 Jun 21;24:367-373. doi: 10.12659/AOT.915182.

Abstract

BACKGROUND Data about application of related haploidentical allogeneic hematopoietic stem cell transplantation (haplo-HSCT) on patients with high-risk or intermediate-risk acute myeloid leukemia (AML) in the first complete remission (CR1) are lacking. In this study, we report the outcomes of using unmanipulated haploidentical allogeneic peripheral blood stem cell transplantation (haplo-PBSCT) as post-remission therapy for patients with high-risk or intermediate-risk AML in CR1. MATERIAL AND METHODS From January 2008 to July 2016, 33 patients diagnosed as high-risk or intermediate-risk AML in CR1 undergoing haplo-PBSCT in our institution were enrolled for analysis. The cumulative incidence of platelet and neutrophil recovery, the occurrence of acute graft-versus-host-disease (GVHD) and chronic GVHD, relapse and non-relapse mortality were assessed. Patients' survival rates were estimated using the Kaplan-Meier method. RESULTS The cumulative incidence of grade 2-4 acute GVHD, overall and extensive chronic GVHD was 18.2%, 9.1%, and 6.1%, respectively. 2-year probability of relapse was 9.1%. Disease-free survival and overall survival at 2 years were 72.7% and 75.8%, respectively. CONCLUSIONS Our results showed that unmanipulated haploidentical transplantation with G-CSF primed PBSC alone as a graft source could be an acceptable alternative post-remission treatment for high-risk or intermediate-risk AML patients in CR1 lacking a matched donor.

摘要

背景

缺乏关于相关单倍体相合异基因造血干细胞移植(haplo-HSCT)应用于处于首次完全缓解(CR1)期的高危或中危急性髓系白血病(AML)患者的数据。在本研究中,我们报告了使用未处理的单倍体相合异基因外周血干细胞移植(haplo-PBSCT)作为处于CR1期的高危或中危AML患者缓解后治疗的结果。材料与方法:2008年1月至2016年7月,纳入了33例在我院接受haplo-PBSCT的诊断为处于CR1期的高危或中危AML患者进行分析。评估血小板和中性粒细胞恢复的累积发生率、急性移植物抗宿主病(GVHD)和慢性GVHD的发生情况、复发率和非复发死亡率。采用Kaplan-Meier法估计患者的生存率。结果:2-4级急性GVHD、总体慢性GVHD和广泛性慢性GVHD的累积发生率分别为18.2%、9.1%和6.1%。2年复发概率为9.1%。2年无病生存率和总生存率分别为72.7%和75.8%。结论:我们的结果表明,对于缺乏匹配供体的处于CR1期的高危或中危AML患者,单独使用G-CSF动员的外周血干细胞作为移植物来源进行未处理的单倍体相合移植可能是一种可接受的缓解后治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9280/6599420/2d4319900df4/anntransplant-24-367-g001.jpg

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