联合克拉屈滨预处理方案在难治/复发性急性髓系白血病患者异基因造血干细胞移植中的疗效观察

目的:评价联合克拉屈滨预处理方案在异基因造血干细胞移植（allo-HSCT）治疗难治/复发性急性髓系白血病（AML）中的疗效。方法:收集并分析2017年4月至2019年10月在我院层流病房行联合克拉屈滨预处理方案并行异基因造血干细胞移植治疗的17例难治/复发性AML患者的临床资料。结果:17例患者均完成造血重建,粒细胞植入中位时间为12(9~20）d,血小板植入中位时间为11(9~30)d。预处理过程中，1例患者出现出血性膀胱炎。4例出现Ⅰ-Ⅱ级急性移植物抗宿主病（aGVHD),随访结束时，11例存活患者中有8例出现局限型慢性移植物抗宿主病（cGVHD)。5例患者于移植后复发,中位复发时间为4（2~19）月。1年总生存率为57.2％，1年无病生存率为55.2％。结论:联合克拉屈滨预处理方案近期疗效较好,在不增加预处理相关不良反应的前提下,可有效提高患者生存率,改善患者的预后。

Observation of curative effect of combined therapy with cladribine in aIlogeneic hematopoietic stem cell transplantation of refractory/relapsed acute myeloid leukemia patients

Objective:To evaluate the efficacy of combined treatment with cladribine in the treatment of refractory/relapsed acute myeloid leukemia(AML)with allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods:The clinical data of 17 patients with refractory/relapsed AML who underwent combined cladribine pretreatment plan and received allo-HSCT in the laminar flow ward of our hospital from April 2017 to October 2019 were collected and analyzed.Results:Hematopoietic reconstruction was completed in all the 17 patients,and the median time of granulocyte implantation was 12 d(9~20 d),and the median time of platelet implantation was 11 d(9~30 d).During the pretreatment,one patient developed hemorrhagic cystitis.4 patients occurred Ⅰ-Ⅱ degree of aGVHD.At the end of follow-up,8 of the 11 surviving patients had localized cGVHD.Five patients relapsed after transplantation,with a median recurrence time of 4 months(2~19 months).The 1-year overall survival rate was 57.2%,and the 1-year disease-free survival rate was 55.2%.Conclusion:The short-term effect of cladribine combined with pretreatment is better,without increasing the adverse reactions related to pretreatment.It can effectively improve the survival rate of patients and improve the prognosis of patients.