地西他滨治疗异基因造血干细胞移植后早期复发的疗效观察

肖方; 刘强; 郭欢绪; 严学倩; 赵辉; 刘利

doi:10.13201/j.issn.1004-2806.2020.01.007

地西他滨治疗异基因造血干细胞移植后早期复发的疗效观察

- 空军军医大学第二附属医院血液科(西安, 710038)

详细信息

通讯作者: 刘利,E-mail:liuli1@medmail.com.cn

中图分类号: R457.7

收稿日期: 2019-05-23

Therapeutic efficacy of decitabine in the treatment of early recurrence after allogeneic hematopoietic stem cell transplantation

- Department of Hematology, the Second Affiliated Hospital of Air Force Medical University, Xi'an, 710038, China

More Information

Corresponding author: LIU Li, E-mail: liuli1@medmail.com.cn

Received Date: 23 May 2019

摘要

摘要: 目的:观察地西他滨单药治疗急性髓系白血病(AML)/骨髓增生异常综合征(MDS)异基因造血干细胞移植后早期复发的疗效。方法:回顾性分析异基因造血干细胞移植后出现微小残留病灶(MRD)阳性的AML/MDS患者19例(其中AML 18例,MDS-EB-1 1例),使用地西他滨治疗。结果:移植后首次检测到MRD阳性中位时间为4(1~44)个月。所有患者使用地西他滨1~4个疗程,中位随访时间25(9~53)个月。15例评价为有效,总有效率78.9%(15/19),且至随访截止持续MRD阴性。9例患者使用1个疗程后MRD阴性,5例使用地西他滨2个疗程后MRD转阴,1例使用地西他滨3个疗程后MRD转阴。4例评价为疗效不佳,其中2例分别使用地西他滨2个及4个疗程,期间MRD持续阳性,后形态学复发;2例用药后1个月复查形态学复发。死亡6例,5例为疾病进展死亡,1例为使用地西他滨7个月后血常规下降,脑出血死亡。MRD阳性患者使用地西他滨治疗后中位无病生存时间17(1~30)个月,中位总生存时间19(2~30)个月。地西他滨治疗后3年预期总生存率68.0%±13.7%,3年预期无病生存率63.0%±11.1%。结论:地西他滨单药治疗可使造血干细胞移植后MRD阳性患者再次达到分子生物学缓解,提高造血干细胞移植疗效,且不良反应小,值得进一步研究。
- 异基因造血干细胞移植 /
- 微小残留病灶 /
- 地西他滨
Abstract: Objective:To evaluate the clinical efficacy of decitabine in the treatment of early recurrence after allogeneic hematopoietic stem cell transplantation.Method:A total of 19 patients with minimal residual disease(MRD) positive after allogeneic hematopoietic stem cell transplantation were enrolled and treated with decitabine in this retrospective analysis,including acute myelogenous leukemia(n=18) and myelodysplastic syndrome-EB-1(n=1).Result:The median time of MRD positive was 4 months(ranging from 1 to 44) after allogeneic hematopoietic stem cell transplantation.All 19 patients received decitabine for 1-4 cycles.The median time of follow-up was 25 months(ranging from 9 to 53).Fifteen patients of them achieved complete responses after receiving the treatment of decitabine,the overall response rate was 78.9%(15/19).However,4 cases had no response.Six patients died.The median time of overall survival was 19 months(ranging from 2 to 30).The median time of event-free survival was 17 months(ranging from 1 to 30).The estimated 3 year overall survival rate was 68.0%±13.7%,and estimated 3 year disease-free survival rate was 63.0%±11.1%.Conclusion:The therapy of single decitabine is effective for the patients had MRD after allogeneic stem cell transplantation.
- allogeneic stem cell transplantation /
- minimal residual diseases /
- decitabine

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