自体骨髓移植治疗急性白血病73例疗效分析

目的：评价自体骨髓移植（ＡＢＭＴ）治疗急性白血病的疗效。方法：自１９８６年１０月至１９９７年１２月，用ＡＢＭＴ治疗急性白血病７３例，中位年龄２５．５（９～４８）岁。其中急性非淋巴细胞白血病（ＡＮＬＬ）４３例（ＣＲ１３５例，ＣＲ２或早期复发８例），急性淋巴细胞白血病（ＡＬＬ）３０例（ＣＲ１２５例，ＣＲ２或早期复发５例）。预处理方案包括环磷酰胺（ＣＴＸ）１２０ｍｇ／ｋｇ＋单次全身照射（ＳＴＢＩ）９～１０Ｇｙ或马利兰（Ｂｕ）１６ｍｇ／ｋｇ或马法兰（Ｍｅｌ）１６０～１８０ｍｇ／ｍ２＋阿糖胞苷（ＡｒａＣ）４ｇ／ｍ２。结果：所有患者移植后均重建造血，中位随访时间８０６（３２～３４００）天，移植相关死亡７例（９．５％），ＡＮＬＬ、ＡＬＬＣＲ１期移植者３年无病生存率分别为５４９％±７．７％和６７．０％±１０６％，复发率３９．３％±９．３％和２３．７％±１０．６％。结论：为降低白血病复发率和提高患者无病生存率，无骨髓供者的ＣＲ１期急性白血病患者适合接受ＡＢＭＴ。

Outcome of autologous bone marrow transplantation in 73 patients with acute leukemia

OBJECTIVE: To evaluate the clinical outcome of autologous bone marrow transplantation(ABMT) in acute leukemias. METHODS: Data of 73 acute leukemia patients performed ABMT in our hospital from October 1986 to December 1997 were retrospectively analyzed. The median age was 25.5(9-48) years. Forty-three of them were ANLL [CR1 35, CR2 or early relapse (ER)8], 30 were ALL (CR1 25, CR2 or ER 5). Conditioning regimens were CTX 120 mg/kg + STBI 9-10 Gy or Bu 16 mg/kg or Mel 160-180 mg/m2 + Ara-C 4 g/m2. RESULTS: All patients engrafted successfully. The median follow-up duration was 806 (32-3400) days. The 3-year probabilities of disease-free survival (DFS) for ANLL and ALL in CR1 were 54.9 +/- 7.7% and 67.0% +/- 10.6%, respectively, and the probabilities of relapse were 39.3% +/- 9.3% and 23.7% +/- 10.6%, respectively. CONCLUSION: To decrease relapse and increase DFS, patients with acute leukemia in CR1 who have no HLA-matched related donor are recommended for ABMT.