成人急性淋巴细胞白血病患者异基因造血干细胞移植预后相关因素探讨

目的：回顾性分析影响成人急性淋巴细胞白血病（ALL）异基因造血干细胞移植（allo—HSCT）后疗效的相关因素。方法：选择1995年-2011年于南方医科大学南方医院血液科接受a110—HSCT的200例ALL患者，分析影响移植疗效的因素，包括年龄、免疫分型、BCR／ABL融合基因、移植前疾病状态、HLA配型、预处理方案、移植物抗宿主病（GVHD）及CsA减免和供体淋巴细胞输注（DLI）等。结果：中位随访时间为891d（367~6212d），复发55例，总复发率为27．5％。死亡82例，总病死率为41．0％。单因素及Cox回归模型分析均显示具有BCR／ABL融合基因及移植时非CR状态是复发与死亡的危险因素。结论：ALL患者预后较差，allo-HSCT后复发率及病死率较高，复发与死亡的危险因素有Ph染色体和移植时非CR状态。

Risk factors in adult acute lymphocytic leukemia after allogeneic hematopoietic stem cell transplanta-tion

Objective： analysis retrospectively the risk factor for prognosis of 200 acute lymphocytic leukemia （ALL） patients. Methods：Two hundred patients with ALL, who underwent allo-HSCT from 1995 to 2011 in Nanfang Hospital of Southern Medical University, were enrolled in this analysis. A number of factors were analyzed, including age, immunophenotyping, BCR/ABL fusion gene, disease status, HLA typing, conditioning regimens, graft versus host disease （GVHD）, and donor lymphocyte infusion. Results： The median follow-up time was 891 days （367-6 212 days）, a total of 55 patients underwent relapse, overall relapse rate was 27.5 %. A total of 82 cases of patients died, the total mortality was 41.0%. Single factor analysis and Cox regression model shown that BCR/ABL fusion gene and the none CR status in transplant are both risk factors for recurrence and death. Conclusion： ALL patients＇ prognosis is poo-rer,the recurrence and mortality rate after allo-HSCT were high. The Ph chromosome and the none CR status with transplant were both risk factor for recurrence and death.