Allogeneic hematopoietic stem cell transplantation for patients with treatment-related acute lymphoblastic leukemia compared with de novo acute lymphoblastic leukemia
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摘要: 目的：回顾性分析成人治疗相关性急性淋巴细胞白血病（t-ALL）与新发急性淋巴细胞白血病（de novo ALL）异基因造血干细胞移植（allo-HSCT）后疗效。方法：分析2006-01-2015-12在北京大学血液病研究所行allo-HSCT的所有成人t-ALL共6例，用巢式病例对照研究的方法选出对照组de novo ALL共30例，比较2组患者接受allo-HSCT后造血植入、移植物抗宿主病、复发及生存情况。结果：t-ALL组与de novo ALL组的3年总体生存率和无白血病生存率分别是63% vs.70%（P=0.26）和62% vs.69%（P=0.36）。t-ALL组无一例复发，de novo ALL组有2例（6.7%）复发。t-ALL组与de novo ALL组的3年累积非复发死亡率分别是33% vs.23%（P=0.23）。结论：本研究结果提示t-ALL移植后疗效接近de novo ALL。尽管t-ALL常规化疗疗效差，但移植能显著改善t-ALL的预后。
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关键词:
- 白血病,淋巴细胞,急性 /
- 治疗相关性 /
- 异基因造血干细胞移植
Abstract: Objective: To retrospectively analyze the outcomes in adult patients with treatment-related acute lymphoblastic leukemia (t-ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and that compared with de novo acute lymphoblastic leukemia (de novo ALL).Method: Six adult patients with t-ALL received allo-HSCT at the Peking University Institute of Hematology between January 1,2006 and December 31,2015.Thirty patients with de novo ALL were selected using the case-pair method.The engraftment,graft versous host disease,relapse and survival of patients receiving allo-HSCT were compared between the two groups.Result: The 3-year overall survival and leukemia-free survival for t-ALL versus de novo ALL patients were 63% vs.70% (P=0.26) and 62% vs.69% (P=0.36),respectively.None of the t-ALL patients experienced leukemia relapse,while 2 cases (6.7%) in the de novo ALL group experienced leukemia relapse.The 3-year cumulative non-relapse mortality rates for t-ALL versus de novo ALL patients were 33% vs.23% (P=0.23).Conclusion: It suggests that the prognosis of t-ALL is comparable to that of de novo ALL after transplantation.Although t-ALL shows poorer prognosis than de novo ALL after conventional therapies,allo-HSCT can markedly improve the prognosis of t-ALL. -
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