非高危急性髓系白血病患者首次完全缓解后行自体与异基因外周血造血干细胞移植的疗效对比

肖函; 王欣; 罗小华; 肖青; 张红宾; 唐晓琼; 刘林; 陈建斌; 杨泽松; 王利

doi:10.16016/j.1000-5404.202005132

您当前的位置：

首页 >

文章列表页 >

非高危急性髓系白血病患者首次完全缓解后行自体与异基因外周血造血干细胞移植的疗效对比

专题报道:血液肿瘤诊治新策略与临床应用 | 更新时间：2026-01-09

- 非高危急性髓系白血病患者首次完全缓解后行自体与异基因外周血造血干细胞移植的疗效对比
- Efficacy of autologous versus allogeneic peripheral blood hematopoietic stem cell transplantation in non-high-risk acute myeloid leukemia patients in first complete remission
- 第三军医大学学报 2020年42卷第17期页码：1717-1723
- 作者机构：
- 作者简介：
- 基金信息：
  
  重庆市科卫联合医学科研项目重点项目(2018ZDXM001);重庆市渝中区科委重点项目(20190121)
- DOI：10.16016/j.1000-5404.202005132
  中图分类号：
- 收稿：2020-05-18，
  
  纸质出版：2020-09-15
- 稿件说明：
移动端阅览
肖函, 王欣, 罗小华, 等. 非高危急性髓系白血病患者首次完全缓解后行自体与异基因外周血造血干细胞移植的疗效对比[J]. 第三军医大学学报, 2020,42(17):1717-1723.

Han XIAO, Xin WANG, Xiaohua LUO, et al. Efficacy of autologous versus allogeneic peripheral blood hematopoietic stem cell transplantation in non-high-risk acute myeloid leukemia patients in first complete remission[J]. Journal of Third Military Medical University, 2020, 42(17): 1717-1723.
肖函, 王欣, 罗小华, 等. 非高危急性髓系白血病患者首次完全缓解后行自体与异基因外周血造血干细胞移植的疗效对比[J]. 第三军医大学学报, 2020,42(17):1717-1723. DOI： 10.16016/j.1000-5404.202005132.

Han XIAO, Xin WANG, Xiaohua LUO, et al. Efficacy of autologous versus allogeneic peripheral blood hematopoietic stem cell transplantation in non-high-risk acute myeloid leukemia patients in first complete remission[J]. Journal of Third Military Medical University, 2020, 42(17): 1717-1723. DOI： 10.16016/j.1000-5404.202005132.

摘要

Abstract

Objective

To compare the efficacy of autologous and allogeneic peripheral blood hematopoietic stem cell transplantation (PB-HCT) for non-high-risk acute myeloid leukemia (AML) patients having achieved first complete remission (CR1).

Methods

A total of 73 patients with CR1 stage AML (non-high risk) who underwent PB-HCT in our department from January 2012 to June 2019 were enrolled in this study

and they were 49 patients receiving allogeneic PB-HCT and 24 getting autologous PB-HCT. The time of hematopoietic reconstruction

required transfusion volume

the number times of early infections

1-year cumulative relapse incidence (RI) and non-relapse mortality (NRM)

1-year overall survival (OS) and leukemia-free survival (LFS) were compared between the 2 groups.

Results

There were no significant differences in hematopoietic reconstruction time

required transfusion volume and the number times of early infections between the 2 groups. As for the autol

ogous PB-HCT group and allogeneic PB-HCT group

1-year RI was 25.4% and 6.2% (

0.01); 1-year NRM was 0.0% and 8.3% (

=0.15); 1-year OS was 95.8% and 89.5% (

=0.80); and 1-year LFS was 74.6% and 85.6% (

=0.07)

respectively. Among the low-risk patients

there were no obvious differences in RI

NRM

LFS

and OS between the 2 groups. For the intermediate-risk patients

1-year NRM and OS were not significantly different

1-year RI was 31.6% and 8.8% (

0.01)

and 1-year LFS was 68.4% and 85.3% (

=0.02)

respectively. Furthermore

the intermediate-risk patients who received MSD (HLA-matched sibling donor) PB-HCT had higher LFS than the autologous group (90.5%

68.4%

0.01)

while the LFS of the patients undergoing haploid-identical PB-HCT was not statistically different from autologous PB-HCT.

Conclusion

Autologous and allogeneic PB-HCT can result in a similar effect in the low-risk AML patients at the CR1 stage. Moreover

allogeneic PB-HCT is more effective for intermediate-risk patients

but only for the patients undergoing MSD PB-HCT. If there is a lack of HLA-matched sibling donor

autologous PB-HCT is an effective alternative.

关键词

Keywords

references

BURNETT A K GOLDSTONE A HILLS R K Curability of patients with acute myeloid leukemia who did not undergo transplantation in first remission J Clin Oncol 2013 31 10 1293 1301 10.1200/jco.2011.40.5977 BURNETT A K, GOLDSTONE A, HILLS R K, et al . Curability of patients with acute myeloid leukemia who did not undergo transplantation in first remission [J ] . J Clin Oncol, 2013, 31(10): 1293-1301. DOI:10.1200/jco.2011.40.5977.

TAKAMI A Hematopoietic stem cell transplantation for acute myeloid leukemia Int J Hematol 2018 107 5 513 518 10.1007/s12185-018-2412-8 TAKAMI A. Hematopoietic stem cell transplantation for acute myeloid leukemia [J]. Int J Hematol, 2018, 107(5):513-518. DOI: 10.1007/s12185-018-2412-8.

YESHURUN M WOLACH O Autologous hematopoietic cell transplantation for AML in first remission—An abandoned practice or promising approach? Semin Hematol 2019 56 2 139 146 10.1053/j.seminhematol.2019.01.001 YESHURUN M, WOLACH O. Autologous hematopoietic cell transplantation for AML in first remission—An abandoned practice or promising approach? [J]. Semin Hematol, 2019, 56(2): 139-146. DOI:10.1053/j.seminhematol.2019.01.001.

ARBER D A ORAZI A HASSERJIAN R The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia Blood 2016 127 20 2391 2405 10.1182/blood-2016-03-643544 ARBER D A, ORAZI A, HASSERJIAN R, et al . The 2016 revision to the World Health Organization classification of myeloid neoplasms and acute leukemia [J ] . Blood, 2016, 127(20):2391-2405. DOI: 10.1182/blood-2016-03-643544.

DÖHNER H ESTEY E H GRIMWADE D Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel Blood 2017 129 4 424 447 10.1182/blood-2016-08-733196 DÖHNER H, ESTEY E H, GRIMWADE D, et al . Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel [J ] . Blood, 2017, 129(4): 424-447. DOI:10.1182/blood-2016-08-733196.

叶珂廖明燕唐晓琼造血干细胞移植治疗急性髓系白血病40例临床观察现代医药卫生 2016 32 7 986 989, 992 10.3969/j.issn.1009-5519.2016.07.009 叶珂, 廖明燕, 唐晓琼, 等.造血干细胞移植治疗急性髓系白血病40例临床观察[J].现代医药卫生, 2016, 32(7): 986-989, 992.DOI: 10.3969/j.issn.1009-5519.2016.07.009.

YE K LIAO M Y TANG X Q Clinical observation on hematopoietic stem cell transplantation for treating 40 cases of acute myeloid leukemia J Mod Med Health 2016 32 7 986 989, 992 10.3969/j.issn.1009-5519.2016.07.009 YE K, LIAO M Y, TANG X Q, et al . Clinical observation on hematopoietic stem cell transplantation for treating 40 cases of acute myeloid leukemia [J ] . J Mod Med Health, 2016, 32(7): 986-989, 992. DOI: 10.3969/j.issn.1009-5519.2016.07.009

CORNELISSEN J J BLAISE D Hematopoietic stem cell transplantation for patients with AML in first complete remission Blood 2016 127 1 62 70 10.1182/blood-2015-07-604546 CORNELISSEN J J, BLAISE D. Hematopoietic stem cell transplantation for patients with AML in first complete remission [J]. Blood, 2016, 127(1): 62-70. DOI:10.1182/blood-2015-07-604546.

魏旭东米瑞华中危AML患者CR1期是首选化疗还是异基因造血干细胞移植? 临床血液学杂志 2019 32 9 665 668 10.13201/j.issn.1004-2806.2019.09.004 魏旭东, 米瑞华.中危AML患者CR1期是首选化疗还是异基因造血干细胞移植? [J].临床血液学杂志, 2019, 32(9): 665-668.DOI: 10.13201/j.issn.1004-2806.2019.09.004.

WEI X D MI R H The first choice of consolidation therapies for intermediate-risk acute myeloid leukemia in first complete remission:Chemotherapy or allogeneic stem cell transplantation? J Clin Hematol 2019 32 9 665 668 10.13201/j.issn.1004-2806.2019.09.004 WEI X D, MI R H. The first choice of consolidation therapies for intermediate-risk acute myeloid leukemia in first complete remission:Chemotherapy or allogeneic stem cell transplantation? [J]. J Clin Hematol, 2019, 32(9): 665-668. DOI: 10.13201/j.issn.1004-2806.2019.09.004.

胡亮钉牛婧文中危急性髓系白血病患者缓解后移植的策略选择临床血液学杂志 2019 32 9 669 671 10.13201/j.issn.1004-2806.2019.09.005 胡亮钉, 牛婧文.中危急性髓系白血病患者缓解后移植的策略选择[J].临床血液学杂志, 2019, 32(9): 669-671.DOI: 10.13201/j.issn.1004-2806.2019.09.005.

HU L D LIU J W Transplantation strategies for patients with intermediate risk acute myeloid leukemia after remission J Clin Hematol 2019 32 9 669 671 10.13201/j.issn.1004-2806.2019.09.005 HU L D, LIU J W. Transplantation strategies for patients with intermediate risk acute myeloid leukemia after remission [J]. J Clin Hematol, 2019, 32(9): 669-671. DOI: 10.13201/j.issn.1004-2806.2019.09.005.

TALLMAN M S WANG E S ALTMAN J K Acute myeloid leukemia, version 3.2019, NCCN clinical practice guidelines in oncology J Natl Compr Canc Netw 2019 17 6 721 749 10.6004/jnccn.2019.0028 TALLMAN M S, WANG E S, ALTMAN J K, et al . Acute myeloid leukemia, version 3.2019, NCCN clinical practice guidelines in oncology [J ] . J Natl Compr Canc Netw, 2019, 17(6): 721-749. DOI:10.6004/jnccn.201 9.0028.

LI Z C LIU Y M WANG Q Autologous stem cell transplantation is a viable postremission therapy for intermediate-risk acute myeloid leukemia in first complete remission in the absence of a matched identical sibling: a meta-analysis Acta Haematol 2019 141 3 164 175 10.1159/000495206 LI Z C, LIU Y M, WANG Q, et al . Autologous stem cell transplantation is a viable postremission therapy for intermediate-risk acute myeloid leukemia in first complete remission in the absence of a matched identical sibling: a meta-analysis [J ] . Acta Haematol, 2019, 141(3): 164-175. DOI:10.1159/000495206.

SHORT N J RAVANDI F How close are we to incorporating measurable residual disease into clinical practice for acute myeloid leukemia? Haematologica 2019 104 8 1532 1541 10.3324/haematol.2018.208454 SHORT N J, RAVANDI F. How close are we to incorporating measurable residual disease into clinical practice for acute myeloid leukemia? [J]. Haematologica, 2019, 104(8): 1532-1541. DOI:10.3324/haematol.2018.208454.

FREEMAN S D HILLS R K VIRGO P Measurable residual disease at induction redefines partial response in acute myeloid leukemia and stratifies outcomes in patients at standard risk without NPM1 mutations J Clin Oncol 2018 36 15 1486 1497 10.1200/JCO.2017.76.3425 FREEMAN S D, HILLS R K, VIRGO P, et al . Measurable residual disease at induction redefines partial response in acute myeloid leukemia and stratifies outcomes in patients at standard risk without NPM1 mutations [J ] . J Clin Oncol, 2018, 36(15):1486-1497. DOI: 10.1200/JCO.2017.76.3425.

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

核仁磷酸蛋白1突变的分子异质性对急性髓系白血病预后的影响

Auer小体对初诊非M3型急性髓细胞白血病患者预后的影响

miRNA-495靶向STYX调节MLL-AF9的急性髓系白血病细胞的增殖和凋亡

305例髓系肿瘤的基因突变图谱比较分析

急性髓系白血病干细胞源性巨噬样细胞生物学特性的研究