造血干细胞移植治疗骨髓增生异常综合征20例疗效分析

目的评价造血干细胞移植（HSCT）治疗骨髓增生异常综合征（MDS）患者的疗效，探讨MDS患者接受HSCT治疗的适应证和时机。方法1993年11月～2007年4月对20例MDS及MDS转急性髓系白血病（AML）患者（男性12例,女性8例,中位年龄39岁）行HSCT治疗。其中18例接受同胞供者异基因外周血干细胞移植（allo—PBSCT）；1例为同基因骨髓移植（Svn—BMT）；1例为无关脐带血移植（CBT），＋25d时移植失败行自体骨髓移植。预处理主要采用修改的Bu／Cv方案。结果3年总生存率（SO）及3年无病生存率均为53.3％±12％；3年复发率（RR）10．8％±7％，移植相关死亡率（TRM）42．6％±12％。截止随访日期，存活11例，中位生存时间16．5（2.0～112）个月。结论HSCT是治疗MDS的有效方法,如有HLA匹配的同胞供者,HSCT可作为MDS患者的一线治疗。

Hematopoietic stem cell transplantation(HSCT) in myelodysplastic syndrome:analysis of 20 cases

Objective To analyse the outcome of the patients with myelodysplastic syndrome （MDS） received hematopoietic stem cell transplantation（HSCT） and explore the indication and optimal time for treating MDS by HSCT. Methods From November 1993 to April 2007 ,a total of 20 patients （male 12,female 8,median age 39 years） with MDS were treated with HSCT. The modified Bu/Cy conditioning regimen was used. Eighteen patients received sibling donated peripheral blood stem cell transplantation （PBSCT） ; t patient received syngeneic bone marrow transplantation （Syn-BMT） and 1 received unrelated cord blood allogeneic stem cell transplantation（CBT）. Results The 3 year-actual overall survival （OS） and disease-free survival （DFS） rates of 20 patients were the same of 53.3 % ± 12 % ,and the relapse rate （RR） was 10.8 % ± 7 % ,and transplant-related mortality was 42.6 % ± 12 %. Eleven cases survived with a median of 16.5（2.0 - 112） months at the end of following-up. Conclusion HSCT is an effective therapy for patients with MDS. For MDS patients with available HLA-identical sibling donors, HSCT should be the first choice of treatment and performed the sooner the better.