脐血移植治疗难治复发急性白血病的临床分析

目的 分析脐血移植(umbilical cord blood transplantation, UCBT)治疗难治复发急性白血病(relapsed/refractory acute leukemia,R/R-AL)患者的临床疗效。方法 回顾性分析2016年1月至2020年12月在湖南省郴州市第一人民医院接受UCBT的22例患者,其中难治复发急性髓系细胞白血病(relapsed/refractory acute myelocytic leukemia,R/R-AML)18例、难治复发急性淋巴细胞白血病(relapsed/refractory acute lymphocytic leukemia, R/R-ALL)4例。结果 ①+42 d粒系植入率为100％(22/22);+100 d巨核系植入率为90.5％(19/21)。②+100 d Ⅲ～Ⅳ度急性移植物抗宿主病(acute graft versus host disease,aGVHD) 累积发生比例为36.4％(8/22);3年慢性移植物抗宿主病(chronic graft versus host disease,cGVHD) 累积发生比例为21.1％(4/19);3年重度cGVHD的累积发生比例为10.5％(2/19)。③3年累积复发率为3.2％;3年总生存率(overall survival, OS)为71.4％;3年无病生存率(disease-free survival, DFS)为70.9％。结论 UCBT治疗R/R-AL患者具有重度cGVHD率低、复发率低、OS和DFS高等特点。

Clinical analysis of umbilical cord blood transplantation in the treatment of refractory and recurrent acute leukemia

Objective To analyze the clinical effect of umbilical cord blood transplantation(UCBT)in the treatment of relapsed/refractory acute leukemia(R/R-AL). Methods A retrospective analysis was performed on 22 patients who received UCBT from January 2016 to December 2020 The First People’s Hospital of Chenzhou, including 18 patients with refractory recurrent relapsed/refractory acute myelocytic leukemia (R/R-AML), 4 patients with acute refractory/relapse acute lymphocytic leukemia(R/R-ALL). Results In the study, the rate of +42 d neutrophils implantation was 100% (22/22), the rate of megakaryocyte implantation on +100 days was 90.5%(19/21). The cumulative incidence of Ⅲ-Ⅳ acute graft versus host disease (aGVHD) at + 100 days was 36.4% (8/22), the cumulative incidence of chronic graft versus host disease (cGVHD) for 3 years was 21.1% (4/19), and the cumulative incidence of severe cGVHD at 3 years was 10.5% (2/19). The 3-year cumulative recurrence rate was 3.2%; the 3-year overall survival (OS) was 71.4%; the 3-year disease-free survival (DFS) was 70.9%. Conclusion R/R-AL patients treated with UCBT had low rate of severe cGVHD, low recurrence rate, and higher OS and DFS.