摘要
目的 评价地西他滨桥接异基因造血干细胞移植(allo-HSCT)治疗骨髓增生异常综合征(MDS)的疗效及安全性.方法 回顾性分析2010年7月至2013年12月于苏州大学附属第一医院血液科接受allo-HSCT的MDS患者的临床特征及疗效,随机抽取25例接受地西他滨桥接allo-HSCT的MDS患者为桥接组,以同期33例未接受地西他滨行allo-HSCT的MDS患者为对照组,观察患者疗效、总生存(OS)及移植物抗宿主病(GVHD)发生情况.结果 桥接组患者移植前骨髓完全缓解率为64.0%(25例中16例),明显高于对照组的15.1%(33例中5例),差异有统计学意义(P<0.05);早期移植相关死亡率低于对照组(4.0%对18.2%),但差异无统计学意义(P=0.106).桥接组移植相关死亡率及2年OS率分别为12.0%及83.0%,与对照组的30.3%及59.0%比较差异均有统计学意义(P值均<0.05).桥接组14例患者发生急性GVHD(aGVHD),其中Ⅰ度7例、Ⅱ度3例、Ⅲ度4例;对照组16例患者发生aGVHD,其中Ⅰ度7例、Ⅱ度8例、Ⅲ度1例.结论 地西他滨桥接allo-HSCT治疗MDS安全且有效.
Objective To evaluate the efficacy of decitabine (DAC) bridging therapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myelodysplastic syndrome (MDS).Methods The clinical characteristics and curative effect of MDS patients who received allo-HSCT from 2010 July to 2013 December were retrospectively analyzed.Of them,25 MDS patients who received decitabine bridging allo-HSCT were randomly selected (referred to as the bridging group),while at the same time another 33 MDS patients who did not receive decitabine for allo-HSCT in MDS were also randomly selected as control group.The effect of decitabine bridging allo-HSCT on the patients' survival and occurrence of graft versus host disease (GVHD) was analyzed.Results With decitabine bridge therapy,64.0% patients (16/25) achieved marrow complete remission before allo-HSCT,while the control group was only 15.1% (5/33,P〈0.05).Decitabine bridging group of early transplant-related mortality was lower than that of the control group (4.0% vs 18.2%),but the difference was not statistically significant (P=0.106).Up to follow-up deadline,the mortality of decitabine bridging group was 12.0%,while that of the control group was 30.3% (P〈0.05).The 2-year OS of decitabine bridging group was 83.0%,while that of the control group was 59.0% (P〈0.05).Of the 14 patients in decitabine bridging group with aGVHD,7 was grade Ⅰ aGVHD,3 grade Ⅱ and 4 grade Ⅲ.Of the 16 patients in control group with aGVHD,7 was grade Ⅰ aGVHD,8 grade Ⅱ and 1 grade Ⅲ.Conclusion Decitabine bridging therapy followed by allo-HSCT in the treatment of MDS is safe and effective.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2015年第2期121-124,共4页
Chinese Journal of Hematology
基金
江苏省医学重点人才项目(RC2007074)
苏州市科技计划(YJS0914)
江苏省临床医学科技专项(BL2012005)
汀苏高校优势学科建设工程
关键词
骨髓增生异常综合征
地西他滨
造血干细胞移植
治疗结果
Myelodysplastic syndrome
Decitabine
Hematopoietic stem cell transplantation
Treatment outcome