挽救性二次异基因造血干细胞移植17例的临床研究

Clinical study of salvage second allogeneic hematopoietic stem cell transplantation in 17 cases

  • 摘要:
    目的  总结分析二次异基因造血干细胞移植治疗首次移植后复发急性白血病的疗效及影响因素。
    方法  回顾性分析北京大学第一医院2005年1月至2024年12月行二次异基因造血干细胞移植的17例急性白血病患者的临床资料。
    结果  17例患者中二次移植后有7例获得长期无病生存状态,第二次移植成功后中位无进展生存期为7个月(8天,69个月),复发病死率为24%,移植相关病死率为35%。
    结论  二次移植是治疗复发难治性急性白血病的有效方式,但移植后复发及移植相关病死率仍较高。患者年龄、第一次移植后复发时间、二次移植前疾病状态均是影响二次移植疗效的因素,患者年轻、晚期复发、二次移植前疾病完全缓解对二次移植后患者获得长期无病生存均有益。

     

    Abstract:
    Objective  To summarize and analyze the efficacy and influencing factors of second allogeneic hematopoietic stem cell transplantation (allo-HSCT) for acute leukemia relapsing after the first allo-HSCT.
    Methods  Clinical data of 17 patients with acute leukemia who underwent second allo-HSCT at Peking University First Hospital from January 2005 to December 2024 were retrospectively analyzed.
    Results  Among the 17 patients, 7 achieved long-term disease-free survival after second transplantation. The median progression-free survival after successful second transplantation was 7 months (range 8 days to 69 months). The relapse fatality was 24%, and the transplant-related fatality was 35%.
    Conclusions  Second transplantation is an effective treatment for relapsed and refractory acute leukemia, but the relapse fatality and transplant-related fatality remain high. Patient age, time of relapse after the first transplantation and disease status before second transplantation are all factors that affect the efficacy of second transplantation. Younger age, late relapse and complete remission of disease before second transplantation are all beneficial for long-term disease-free survival after second transplantation.

     

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