异基因造血干细胞移植后白血病复发的危险因素

目的探讨异基因造血干细胞移植后白血病复发的危险因素。方法回顾性选择71例行异基因造血干细胞移植术的白血病患者,采用单因素、COX多因素回归法分析71例患者性别、年龄、疾病类型、诱导疗程数、初诊白细胞计数、巨细胞病毒感染、移植物来源、供受者HLA配型、急性移植后移植物抗宿主病、慢性移植后移植物抗宿主病与复发的相关性。结果71例患者中14例复发。单因素分析结果表明,初诊白细胞计数、诱导疗程数、移植物来源及慢性移植物抗宿主病史是异基因造血干细胞移植后复发的危险因素,P<0.05;Cox多因素回归分析结果表明,诱导疗程数多、无慢性移植物抗宿主病是异基因造血干细胞移植后复发的独立危险因素,P<0.05。结论无慢性移植物抗宿主病、诱导疗程数多是异基因造血干细胞移植后复发的危险因素。

The Risk Factors of Leukemia Recurrence after Allogeneic Hematopoietic Stem Cell Transplantation

Objective To investigate the risk factors of leukemia recurrence after allogeneic hematopoietic stem cell transplantation. Methods 71 leukemia patients with allogeneic hematopoietic stem cell transplantation were retrospectively selected,the correlation between gender,age,disease type,induction courses number,initial white blood cell count,cytomegalovirus infection,graft source,donor HLA match,acute graft-versus-host disease,chronic graft-versus-host disease and recurrence in 71 patients were analyzed by the univariate and COX multivariate regression methods. Results 14 cases in 71 patients with leukemia were relapsed. Univariate analysis showed that the initial white blood cell count,induction duration,graft origin and chronic graft-versus host history were risk factors for recurrence after allogeneic hematopoietic stem cell transplantation,P < 0. 05;Cox multivariate regression analysis showed that multiple induction courses and chronic graft-versus host disease were independent risk factors for recurrence after allogeneic hematopoietic stem cell transplantation,P < 0. 05. Conclusion No chronic graft-versus host disease and more induction courses number were risk factors for recurrence after allogeneic hematopoietic stem cell transplantation.