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目的:回顾性分析成人治疗相关性急性淋巴细胞白血病(t-ALL)与新发急性淋巴细胞白血病(de novo ALL)异基因造血干细胞移植(allo-HSCT)后疗效。方法:分析2006-01-2015-12在北京大学血液病研究所行allo-HSCT的所有成人t-ALL共6例,用巢式病例对照研究的方法选出对照组de novo ALL共30例,比较2组患者接受allo-HSCT后造血植入、移植物抗宿主病、复发及生存情况。结果:t-ALL组与de novo ALL组的3年总体生存率和无白血病生存率分别是63%vs.70%(P=0.26)和62%vs.69%(P=0.36)。t-ALL组无一例复发,de novo ALL组有2例(6.7%)复发。t-ALL组与de novo ALL组的3年累积非复发死亡率分别是33%vs.23%(P=0.23)。结论:本研究结果提示t-ALL移植后疗效接近de novo ALL。尽管t-ALL常规化疗疗效差,但移植能显著改善t-ALL的预后。
Objective: To retrospectively analyze the curative effect of allo-HSCT in adult treatment-related acute lymphoblastic leukemia (t-ALL) and new-onset de novo ALL (allogeneic hematopoietic stem cell transplantation). Methods: The data of 6 cases of all-adult t-ALL from allo-HSCT in Peking University Institute of Hematology were analyzed from January 2006 to December 2015. Thirty cases of control group de novo ALL were selected by nested case-control study. The hematopoietic engraftment, graft versus host disease, relapse and survival were compared between the two groups after receiving allo-HSCT. Results: The 3-year overall survival and leukemia-free survival of t-ALL and de novo ALL patients were 63% vs. 70% (P = 0.26) and 62% vs.69% (P = 0.36), respectively. None of the patients in the t-ALL group relapsed, and two patients (6.7%) in the de novo ALL group relapsed. The 3-year cumulative non-recurrent mortality rates in t-ALL and de novo ALL groups were 33% vs 23%, respectively (P = 0.23). Conclusion: The results of this study suggest that the efficacy of t-ALL transplantation is similar to that of de novo ALL. Although t-ALL routine chemotherapy is ineffective, transplantation can significantly improve the prognosis of t-ALL.