髓系抗原表达对急性淋巴细胞白血病患者异基因造血干细胞移植后造血重建及疾病预后的影响

本研究旨在观察髓系抗原表达对急性淋巴细胞白血病异基因造血干细胞移植（allo-HSCT）后造血重建及疾病预后的影响.回顾性分析西安交通大学医学院第一附属医院血液科2008年1月至2014年4月期间20例行allo-HSCT的急性淋巴细胞白血病患者的临床资料,其中5例伴有髓系抗原表达（My＋ ALL）,15例不伴髓系抗原表达（My-ALL）.观察My＋ ALL与My-ALL患者allo-HSCT后造血重建及疾病预后的差异.结果表明,My＋ALL患者allo-HSCT后血小板植入不良较My-ALL患者多见.My＋ ALL患者中3例出现皮肤慢性移植物抗宿主病（cGVHD）（其中2例局限型,1例皮肤广泛型）;My-ALL患者中3例出现急性移植物抗宿主病（aGVHD）,其中2例为Ⅰ度,1例为Ⅱ度;5例出现cGVHD,其中3例局限型,2例广泛型.两组患者1年及2年总生存率分别为80％和85.7％,53％和69.8％,1年及2年疾病无进展生存率分别为53.3％和54.7％,26％和27.4％,两组间差异无统计学意义（P＞0.05）.结论髓系抗原表达可能对ALL患者异基因造血干细胞移植后血小板植入有不良影响.My＋ ALL与My-ALL患者移植后1年及2年总生存率及无病生存率间差异无统计学意义.

Effects of Myeloid Antigen Expression on Hematopoietic Reconstitution and Disease Prognosis in Acute Lymphocytic Leukemia Patients after Allogeneic Stem Cell Transplantation

This study was aimed to investigate the effects of myeloid antigen expression on hematopoietic reconstitution and disease prognosis in acute lymphocytic leukemia patients post-ailogeneic stem cell transplantation（ allo- HSCT）. Clinical data of 20 patients with acute lymphocytic leukemia in Department of Hematology of the First Affiliated Hospital of Xi＇an Jiaotong University from 2008 January to 2014 April were retrospectively analyzed, in which 5 cases were with myeloid antigen （My ＋ ALL）, while 15 patients were without myeloid antigen expression （My- ALL）. Differences in prognosis and hematopoietic reconstitution post-allo-HSCT were observed in My ∽ ALL and My- ALL patients. The results showed that the poor platelet engraftment in patients with My＋ ALL was found more than that in My-ALL patients. Three My - ALL patients experienced skin chronic graft versus host disease （cGVHD） including local in 2 cases and extensive in one case, and 3 My- ALL patients developed grade Ⅰ-Ⅱacute GVHD, while five patients of My- ALL expeienced cGVHD including local in 3 cases, extensive in 2 cases. One and two year overall survival rate of My∽ ALL and My- ALL patients was 80% and 85.7%, 53% and 69.8% respectively, one and two year progress-free survival rate was 53.3% and 54.7%, 26% and 27.4%, respectively. And there was no significant statistical difference between two groups （ P 〉 0.05 ）. It is concluded that the myeloid antigen expression may impact the platelet engraftment post-transplantation. There is no significant difference between one and two year overall survival rate and progress-free survival rate of My- ALL and My- ALL patients after allogeneic stem cell transplantation.