Efficiency and safty of haploidentical hematopoietic stem cell transplantation for myelodysplastic syndrome evolved from aplastic anemia
Author:
Affiliation:
Fund Project:
摘要
|
图/表
|
访问统计
|
参考文献
|
相似文献
|
引证文献
|
资源附件
|
文章评论
摘要:
目的：回顾性分析应用HLA半相合异基因外周血造血干细胞移植（haploidentical hematopoietic stem cell transplantation，haplo-HSCT）治疗再生障碍性贫血（aplastic anemia，AA）克隆演变继发骨髓增生异常综合征（secondary myelodysplastic syndrome，sMDS）的疗效和安全性。方法：本中心5例AA患者经强化免疫抑制治疗后演变为sMDS，均采用haplo-HSCT，观察植入情况，移植物抗宿主病（graft versus host disease，GVHD）、移植相关并发症和移植相关病死率（transplant related modify，TRM）、总体生存（overall survival，OS）时间等。结果：5例中位OS时间63个月（41.9~149.3个月），移植后中位OS时间12.9个月（2.4~36.5个月），1年累积生存率60%，TRM 40%。移植后粒系植入时间18 d（14~22 d），血小板植入时间21 d（15~65 d），总植入率100%。60%（3/5）患者发生Ⅰ~Ⅲ度急性移植物抗宿主病（acute graft versus host disease，aGVHD），无Ⅳ度aGVHD发生，20%（1/5）患者发生慢性移植物抗宿主病（chronic graft versus host disease，cGVHD）。中位随访时间63个月（41.9~149.3个月）。结论：在无合适HLA相合供者情况下，haplo-HSCT可作为AA演变MDS患者的有效治疗策略。
Abstract:
Objective：To evaluate the efficiency and safety of haploidentical hematopoietic stem cell transplantation（haplo-HSCT）for treatment of secondary myelodysplastic syndrome（sMDS） after AA. Methods：Evaluation of therapeutic effect，incidence rate of aGVHD and cGVHD，complications and overall survival（OS） of 5 AA post MDS patients who received haplo-HSCT in this center，and compared with other treatments for sMDS evolved from AA. Results：Among 5 patients，median OS was 63 months（range from 41.9 to 149.3 months），OS after HSCT was 12.9 months（range from 2.4 to 36.5 months）. 1-year event free survival was 60%. All patients achieved neutrophil and platelet engraftment at a median of 18 days（range from 14 to 22 days）and 21 days（range from 15 to 65 days）respectively. 3 occurred Ⅰ~Ⅲ° acute graft versus host disease（aGVHD），and 1 with chronic graft versus host disease（cGVHD）. Medial follow-up was 63 months（range from 41.9 to 149.3 months）. Conclusion：The haplo-HSCT can be an opition for sMDS from AA patients in case of an HLA-identical donor is not available.
