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目的探讨异基因造血干细胞移植(allo-HSCT)治疗慢性粒细胞白血病(CML)的疗效及预后因素分析。方法选择104例CML患者,采用Bu+Cy、改良Bu+Cy、TBI+CY及非清髓方案预处理后行allo-HSCT治疗。结果除1例未植活外,其余均持久性植活。3年无病生存率(DFS)为74.5%,5年累积生存率(OS)为70%。CML慢性期移植、Ⅰ～Ⅱ度急性移植物抗宿主病(GVHD)患者3年DFS分别高于CML加速期/急变期移植、Ⅲ～Ⅳ度急性GVHD患者。多因素Cox回归分析显示,疾病状态、移植类型、急性GVHD的严重程度是异基因HSCT患者长期生存的独立影响因素。结论慢性期且有HLA相合同胞供者的CML患者行allo-HSCT可获得较高长期生存率。
Objective To investigate the efficacy and prognostic factors of allo-HSCT in the treatment of chronic myeloid leukemia (CML). Methods A total of 104 patients with CML were selected and allo-HSCT was treated with Bu + Cy, modified Bu + Cy, TBI + CY and non-myeloablative regimens. Results except 1 case not alive, the rest are permanently planted. The 3-year disease-free survival (DFS) was 74.5% and the 5-year cumulative survival (OS) was 70%. The 3-year DFS of patients with chronic myelogenous leukemia (CML) stage Ⅰ ~ Ⅱ acute graft-versus-host disease (GVHD) were significantly higher than those of CML accelerated / blast crisis stage and Ⅲ ~ Ⅳ acute GVHD patients, respectively. Multivariate Cox regression analysis showed that disease status, graft type, and severity of acute GVHD were independent predictors of long-term survival in patients with allogeneic HSCT. Conclusion Allo-HSCT in chronic phase CML patients with HLA-identical sibling donors can achieve a higher long-term survival rate.