MAC方案预处理自体骨髓移植治疗急性早幼粒细胞白血病临床研究

目的探索一套高效治愈急性早幼粒细胞白血病（APL）的方案。方法44例APL患者首先口服全反式维甲酸（ATRA）诱导缓解，再给予2疗程DA方案化疗巩固，再以MAC方案预处理自体骨髓移植（ABMT）进行强化，最后间断口服两个靶向药物ATRA和砷剂维持治疗3年。结果44例患者，中位随访时间69月。无治疗相关死亡，复发1例（复发率2．3％）。3年EFS为（96．4±3．4）％，3年总0s为（98．2±1．3）％；7年EFS为（96．4±3．4）％，7年总OS为（97．3±1．2）％。结论MAC方案预处理ABMT治疗APL操作便利、毒副作用可控、复发率低，可能成为高效治愈APL的治疗方案。

A clinical research of using autologous bone marrow transplantation with MAC conditioning regimen in the treatment of acute promyelocytic leukemia

Objective To investigate an effective method for curing acute promyelocytic leukemia （APL）. Methods 44 APL patients were received treatment consisted of oral administered all- trans retinoic acid （ATRA） as induction followed by 2 courses of DA protocol chemotherapy as consolidation. Then these patients were treated with ABMT （autologous bone marrow transplantation）following MAC（Melphalan, Am- C and Cyclophosphamide） conditioning regimen as enhancement. At last, they had taken two targeted drugs（ATRA and arsenical） intermit- tently as maintenance therapy for $ years. Results The median follow - up time was 69 months. In this period, there is no treatment - related death, and only one patient relapsed （recurrence rate 2.3 % ）. The 3 - year event -free survival （EFS） was （96.4 ± 3.4）%, the 3- year overall survival （OS） was （98.2 ± 1.3）%; the 7- year EFS was （96.4 ± 3.4） %, and the 7 - year OS was （97.3 ± 1.2） %. Conclusion ABMT with MAC con- ditioning regimen might become an effective treatment method for curing APL, for it was convenient and had con- trollable side effects, low recurrence rate.