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单倍体相合大剂量体外非T细胞去除外周血造血干细胞移植治疗成人Ph(+)急性淋巴细胞白血病的临床疗效分析

[Clinical efficacy analysis of haploidentical high-dose in vitro non-T-cell-depleted peripheral blood hematopoietic stem cell transplantation for the treatment of adult patients with Ph(+) acute lymphoblastic leukemia].

作者信息

Xu J L, Du X F, Yuan H L, Wang H B, Chen G, Yang R X, Zhang K L, Gulibadanmu Aizezi, Qu J H, Jiang M

机构信息

Hematologic Disease Center, the First Affiliated Hospital of Xinjiang Medical University, Institute of Hematology of Xinjiang Uygur Autonomous Region, Urumqi 830054, China.

The People's Hospital of Anyang, Anyang 455000, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2025 Mar 14;46(3):231-237. doi: 10.3760/cma.j.cn121090-20240411-00134.

Abstract

To investigate the clinical efficacy of haploidentical high-dose in vitro non-T-cell-depleted peripheral blood hematopoietic stem cell transplantation (haplo-HDPSCT) in treating adult patients with Ph(+) acute lymphoblastic leukemia (Ph(+) ALL) . This retrospective analysis was conducted on the clinical efficacy of 25 adult patients with Ph(+) ALL who underwent haplo-HDPSCT from July 2011 to June 2022 at our hospital. This study included 25 patients with a median age of 27 (16-61) years, consisting of 12 males and 13 females. CR1 and ≥CR2 before transplantation were found in 23 and 2 cases, positive and negative minimal residual lesions were observed in 8 and 17 cases, and myeloablative conditioning and reduced-intensity conditioning were reported in 21 and 4 cases, respectively. Hematopoietic function was restored in all 25 patients after stem cell infusion. Of the 25 patients who underwent transplantation, 16 developed acute graft-versus-host disease (aGVHD). The cumulative incidence rates of Ⅱ-Ⅳ and Ⅲ-Ⅳ aGVHD were (40.4±11.3) % and (4.8±4.6) %, respectively. Four patients experienced relapse after transplantation, the cumulative relapse rates at 1 and 2 years after transplantation were (4.0±3.9) % and (14.5±7.9) %, respectively. The 2-year overall survival rate after transplantation was (81.3±8.5) % and the disease-free survival rate was (77.1±9.1) %. This study reveals that the unique haplo-HDPSCT protocol achieves good clinical efficacy in Ph(+) ALL treatment.

摘要

探讨单倍体相合高剂量体外非T细胞去除外周血造血干细胞移植(haplo-HDPSCT)治疗成人Ph(+)急性淋巴细胞白血病(Ph(+) ALL)的临床疗效。对2011年7月至2022年6月在我院接受haplo-HDPSCT的25例成人Ph(+) ALL患者的临床疗效进行回顾性分析。本研究纳入25例患者,中位年龄27(16 - 61)岁,其中男性12例,女性13例。移植前CR1和≥CR2分别见于23例和2例,微小残留病变阳性和阴性分别见于8例和17例,清髓性预处理和减低强度预处理分别见于21例和4例。干细胞输注后所有25例患者造血功能均恢复。25例移植患者中,16例发生急性移植物抗宿主病(aGVHD)。Ⅱ-Ⅳ度和Ⅲ-Ⅳ度aGVHD的累积发生率分别为(40.4±11.3)%和(4.8±4.6)%。4例患者移植后复发,移植后1年和2年的累积复发率分别为(4.0±3.9)%和(14.5±7.9)%。移植后2年总生存率为(81.3±8.5)%,无病生存率为(77.1±9.1)%。本研究表明,独特的haplo-HDPSCT方案在Ph(+) ALL治疗中取得了良好的临床疗效。

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