自体造血干细胞移植治疗恶性血液病患者118例生存分析

Survival of 118 patients with malignant hematological disease treated by autologous hematopoietic stem cell transplantation

摘要:

目的：评价自体造血干细胞移植（autologous hematopoietic stem cell transplantation，auto-HSCT）治疗血液系统恶性肿瘤的疗效。方法：回顾性分析2007年3月至2013年7月接受auto-HSCT的118例血液病患者的临床资料，急性髓系白血病23例，恶性淋巴瘤69例，多发性骨髓瘤26例。对患者总生存率（overall survival，OS）、无病生存率（disease free survival，DFS）、复发率等进行统计。结果：除1例因感染未成功植入外，余117例患者均获得造血重建，中性粒细胞≥0.5×109个/L平均时间为9.8 d，血小板≥20×109个/L平均时间为12.3 d，中位生存时间为47.6月（1～80）月，3年OS及DFS分别为62.3%、54.3%，5年OS及DFS分别为49.0%、42.8%，累积复发率为28.0%，其中淋巴瘤预后较白血病、骨髓瘤较好（P＜0.05）。结论：auto-HSCT治疗急性白血病有效，能明显提高淋巴瘤及多发性骨髓瘤患者生存期。多发性骨髓瘤应个体化综合治疗。

Abstract:

Objective：To evaluate the clinical efficacy of autologous hematopoietic stem cell transplantation（auto-HSCT） in the treatment of malignant hematological diseases. Methods：The clinical data of 118 patients with hematological diseases who received auto-HSCT were collected. Of the 118 patients，23 were acute leukemia（AL），69 were malignant lymphoma（ML） and 26 were multiple myeloma（MM）. The overall survival（OS），disease free survival（DFS），and the relapse rate were analyzed. Results：Totally 117 patients engrafted successfully，except one patient died because of infection. The average time was 9.8 d for neutrophil reconstruction（≥0.5×109/L），and 12.3 d for platelet reconstruction（≥20×109/L）. Median survival time was 47.6（1-80） months. The 3-year OS and DFS were 62.3% and 54.3%，the 5-year OS and DFS were 49.0% and 42.8%，and the cumulative relapse frequency was 28.0%.The prognosis of ML was better than that of AL and MM（P<0.05）. Conclusion：Auto-HSCT is effective for AL. Auto-HSCT can obviously prolong the survival time of ML and MM patients，and the MM should get individualized treatment.