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目的探讨同基因造血干细胞移植(syn-HSCT)治疗白血病的临床效果。方法观察1996年1月至2008年8月中山大学附属第一医院血液科收治的7例syn-HSCT治疗白血病患者的造血重建情况、远期疗效及移植相关并发症,以108例异基因全相合造血干细胞移植(allo-HSCT)、50例自体造血干细胞移植(auto-HSCT)为对照。结果采用syn-HSCT、allo-HSCT和auto-HSCT治疗的3组患者中性粒细胞≥0.5×109/L的时间分别为(13.5±3.1)d、(14.6±4.5)d和(12.9±4.1)d,血小板≥20×109/L的时间分别为(18.7±7.3)d、(21.2±5.1)d和(25.3±9.4)d,3组之间比较差异无统计学意义(P>0.05);syn-HSCT组和allo-HSCT组比较,5年无病存活(DFS)率、总存活(OS)率及复发率比较差异均无统计学意义(P>0.05),但这两组与auto-HSCT组比较,在5年DFS、OS及复发率方面差异均有统计学意义(P<0.05);与allo-HSCT比较,syn-HSCT与auto-HSCT都具有较低的移植相关并发症和移植相关病死率。结论syn-HSCT具有存活率高、复发率低、移植相关并发症及病死率少的优点,可作为治疗白血病的有效方法。
Objective To investigate the clinical effect of syn-HSCT on leukemia. Methods The hematopoietic reconstitution, long-term efficacy and transplantation-related complications of 7 syn-HSCT leukemia patients admitted to Department of Hematology, First Affiliated Hospital of Sun Yat-sen University from January 1996 to August 2008 were retrospectively analyzed. 108 cases of allogeneic coincidence Hematopoietic stem cell transplantation (allo-HSCT) and 50 cases of auto-HSCT were used as control. Results The time of neutrophil≥0.5 × 109 / L in the three groups treated with syn-HSCT, allo-HSCT and auto-HSCT were (13.5 ± 3.1) days, (14.6 ± 4.5) days and (12.9 ± 4.1 days) ) d and platelets ≥20 × 109 / L were (18.7 ± 7.3) days, (21.2 ± 5.1) days and (25.3 ± 9.4) days, respectively. There was no significant difference between the three groups (P> 0.05) There was no significant difference in 5-year disease-free survival (DFS), overall survival (OS) and recurrence between syn-HSCT group and allo-HSCT group (P> 0.05) -HSCT group, there were significant differences in 5-year DFS, OS and recurrence rate (all P <0.05). Compared with allo-HSCT, both syn-HSCT and auto-HSCT had lower transplant-related complications and Graft-related mortality. Conclusion syn-HSCT has the advantages of high survival rate, low recurrence rate, fewer transplant-related complications and less mortality, which can be used as an effective method for the treatment of leukemia.