摘要
目的:进一步总结单倍体相合造血干细胞移植的临床经验,并探讨其疗效。方法:比较83例单倍体移植和本移植中心同期73例同胞全相合移植的疗效,并分析影响移植后生存的相关危险因素。结果:单倍体移植组与全相合移植组在造血重建、发生移植物抗宿主病(GVHD)、总生存(OS)、无病生存(DFS)、移植后复发及移植相关死亡率(TRM)等方面均无显著性差别;多因素分析显示,移植前的疾病状态、移植后复发及出现Ⅲ-Ⅳ度急性GVHD是影响移植后生存的危险因素,相对风险(RR)分别为3.1(95%CI,1.7-5.4),3.5(95%CI,2.0-6.2)和2.5(1.4-4.6)(P<0.05)。结论:应用现有的移植体系进行单倍体移植的疗效与同胞全相合移植相当,移植前的疾病状态及移植后是否出现重度急性GVHD对移植后患者的生存具有重要意义。
Objective: To summarize the clinical experience and evaluate the efficacy of haploidentical HSCT. Methods: The survival rates of 156 patients receiving either haploidentical( 83 cases) or HLA-identical( 73 cases) transplantation for hematologic diseases w ere compared and risk factors related to overall survival( OS) w ere analyzed. Results:HLA-identical and haploidentical cohorts w ere not statistically different in the hematopoietic reconstitution,incidence of acute and chronic graft-versus-host disease( GVHD),OS,disease-free survival( DFS),relapse and treatment-related mortality( TRM) after transplantation. M ultivariate analysis show ed that advanced disease status,relapse and grade III- IV acute GVHD w ere independent prognostic indictors for OS w ith relative risk( RR) of 4. 8( 95% CI 2. 2- 10. 1),4. 3( 95% CI 2. 6- 8. 0) and 3. 3( 95% CI 1. 6- 7. 0),respectively( P < 0. 05). Conclusion: Haploidentical transplantation w ith the present conditioning can achieve the therapeutic effects comparable to HLA-identical sibling transplantation. Disease status before transplantation and the presence or not of severe GVHD after transplantation have important significance for the long-term survival after transplantation.
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2016年第3期833-839,共7页
Journal of Experimental Hematology
基金
国家自然科学基金(U1504806)
关键词
单倍体相合异基因造血干细胞移植
移植物抗宿主病
恶性血液病
haploidentical hematopoietic stem cell transplantation
graft-versus-host disease
hematological malignancy
