急性白血病行自体外周血造血干细胞移植治疗的临床疗效分析

目的：探讨自体外周血造血干细胞移植(auto-PBSCT)治疗急性白血病(AL)的临床疗效。方法回顾性分析第三军医大学大坪医院野战外科研究所2006年3月至2015年12月首次行 auto-PBSCT 治疗的急性白血病患者19例,其中急性髓细胞白血病(AML)12例,急性淋巴细胞白血病(ALL)7例；男10例,女9例,平均年龄39.4(16~64)岁。均在诱导缓解和巩固强化后,采集自体外周血干细胞并行 auto-PBSCT,术后定期随访及维持治疗。结果19例患者均获得造血功能重建,无一例发生移植相关死亡；12例 AML 患者平均随访时间38.3(9~93)个月,6例(50.0%)仍存活,6例(50.0%)持续完全缓解(CR),3年总生存(OS)率50%(6/12)；7例 ALL 患者平均随访时间28.7(3~106)个月,4例(57.1%)存活,3例(42.9%)持续 CR,3年 OS 率71.4%；所有患者的死亡均因白血病本病复发所致。结论auto-PBSCT 可提高 AL 患者的总生存(OS)率和无白血病生存(DFS)率,是无条件行异基因造血干细胞移植(allo-HSCT)的 AL 患者可供选择的一个治疗方案。

Clinical Efficacy of Autologous Peripheral Blood Stem Cell Transplantation for Acute Leukemia

Objective To investigate the clinical efficacy of autologous peripheral blood stem cell transplantation (auto-PBSCT)for adult patients with acute leukemia (AL).Methods The retrospective analysis was conducted in 1 9 AL cases of primary auto-PBSCT from March of 2006 to December of 201 5 in Daping Hospital of Third Military Medical University,which consisted of 12 cases of acute lymphoblastic leukemia (AML)and 7 cases of acute myeloid leukemia (ALL).There were 10 males and 9 females,with an average age of 39.4.All the patients received auto-PBSCT after the induced remission and the consolidated and intensified therapy.The clinical follow-ups were performed. Results The hematopoiesis recovered in all the 1 9 patients and there was no transplantation-related death.The average follow-up time of the 12 AML patients was 38.3 months.The overall survival rate was 50% and all the 6 survivors were still in continuous complete remission (CR).The average follow-up time of the 7 ALL patients was 28.7 months.The overall survival rate was 57.1% and 3 survivors out of 4 still lived with continuous CR.All the death was caused by leukemia relapse.Conclusion The overall and leukemia-free survival rate of the patients with acute leukemia can be improved by auto-PBSCT.Therefore,auto-PBSCT can be an alternative treatment for patients who are incapable of being treated with allogeneic hematopoietic stem cell transplantation.