论文部分内容阅读
异基因造血干细胞移植是唯一可以治愈慢性髓系白血病(CML)的治疗方案。甲磺酸伊马替尼(IMA)治疗CML虽然疗效显著,但始终不能根除白血病干细胞,也无大宗病例报道表明IMA可以停药。异基因造血干细胞移植是CML加速期、急变期和T315 I突变的一线治疗,也是第2代酪氨酸激酶抑制剂(TKI),如达沙替尼、尼罗替尼治疗失败的选择;对于经济落后的地区,儿童患者异基因造血干细胞移植可能是最为经济有效的治疗手段。移植前予IMA并不提高移植相关病死率和复发率,应将IMA靶向治疗药物与传统异基因造血干细胞移植相结合,针对每例患者选择最佳个体化治疗方案。
Allogeneic hematopoietic stem cell transplantation is the only cure for chronic myeloid leukemia (CML). Although the curative effect of CML with imatinib mesylate (IMA) is notable, leukemic stem cells can not be eradicated at all, and there are not many reports of IMA that can be stopped by IMA. Allogeneic hematopoietic stem cell transplantation is a first-line treatment for the accelerated phase of CML, the blast crisis, and the T315I mutation and is also a second-generation tyrosine kinase inhibitor (TKI), such as choice of treatment failure with dasatinib or nilotinib; In economically underdeveloped areas, allogeneic hematopoietic stem cell transplantation in children may be the most cost-effective treatment. IMA before transplantation does not increase the transplant-related mortality and relapse rate, the IMA target therapy should be combined with traditional allogeneic hematopoietic stem cell transplantation for each patient to choose the best individualized treatment options.