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儿童急性淋巴细胞白血病第二次完全缓解期的异基因造血干细胞移植——匹配的亲属供体和非亲属供体移植后的相似结局:西班牙儿童血液和骨髓移植工作组(Getmon)的一项研究

Allogeneic hemopoietic stem cell transplantation for childhood acute lymphoblastic leukemia in second complete remission-similar outcomes after matched related and unrelated donor transplant: a study of the Spanish Working Party for Blood and Marrow Transplantation in Children (Getmon).

作者信息

Muñoz A, Diaz-Heredia C, Diaz M A, Badell I, Verdeguer A, Martinez A, Gomez P, Perez-Hurtado J M, Bureo E, Fernandez-Delgado R, Gonzalez-Valentin M E, Maldonado M S

机构信息

Hospital Ramon y Cajal-University of Alcala, Madrid, Spain.

出版信息

Pediatr Hematol Oncol. 2008 Jun;25(4):245-59. doi: 10.1080/08880010802016557.

Abstract

The authors report the results of 58 children with ALL in 2CR after related (n = 31) or unrelated (n = 27) AHSCT. Characteristics at diagnosis and initial and after relapse antileukemic treatment were similar in the related donor (RD) and the unrelated donor (UD) groups. Conditioning consisted of TBI/CY +/- VP-16 for patients > or = 3 years old (n = 43) and Bu/CY for the rest. Median recipient age was 8 years (range 1-17) in the RD and 9 years (range 3-14) in the UD group. Median follow-up was 54 months (range 24-80) and 52 months (range 22-85) in the RD and the UD groups repectively. The 5-year EFS probability was 43 +/- 9% for the RD group and 36 +/- 9% in the UD group (p = .25). The transplant-related mortality was 16% in the RD and 37% in the UD group (p = .016). In the RD group 36.7% of patients relapsed versus 18.6% in the UD group (p = .05). GvHD associated with organ failure or infection caused most of the transplant-related deaths in both groups. Survivor quality of life for both groups was good (Lansky score < or = 90).

摘要

作者报告了58例接受相关(n = 31)或无关(n = 27)异基因造血干细胞移植(AHSCT)后处于第二次完全缓解(2CR)的急性淋巴细胞白血病(ALL)患儿的结果。相关供体(RD)组和无关供体(UD)组在诊断时、初始及复发后抗白血病治疗时的特征相似。≥3岁的患者(n = 43)预处理方案为全身照射(TBI)/环磷酰胺(CY)±依托泊苷(VP - 16),其余患者采用白消安(Bu)/CY。RD组中位受者年龄为8岁(范围1 - 17岁),UD组为9岁(范围3 - 14岁)。RD组和UD组的中位随访时间分别为54个月(范围24 - 80个月)和52个月(范围22 - 85个月)。RD组5年无事件生存率(EFS)概率为43±9%,UD组为36±9%(p = 0.25)。RD组移植相关死亡率为16%,UD组为37%(p = 0.016)。RD组36.7%的患者复发,UD组为18.6%(p = 0.05)。两组中与移植物抗宿主病(GvHD)相关的器官衰竭或感染导致了大部分移植相关死亡。两组幸存者的生活质量良好(兰斯基评分≤90)。

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