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目的 探讨造血干细胞移植 (SCT)的应用及改善预后的措施。方法 总结 1 998年 8月底中国骨髓移植登记处 (CBMTR)收到的全国登记的SCT病例资料 ,统计患者长期生存率和复发率。结果 迄今国内有 68个单位已开展SCT ,其中 3 0个单位已开展异基因SCT。截止到 1 998年 8月底 ,全国已登记SCT患者 1 84 0例 ,其中 3 8.6%为异基因移植 ,59.0 %为自体SCT ,9例为同基因移植。 1 979~1 998年的统计资料表明 ,异基因SCT后 3年无病生存率 (DFS) :急性髓系白血病 (AML)第 1次完全缓解期 (CR1)患者为 70 .0 % ,急性淋巴细胞白血病 (ALL)CR1患者为 4 8.2 % ,慢性髓系白血病第 1次慢性期(CP1)患者为 64 .2 %。AMLCR1和多次CR患者自体移植后疗效相近 ,而ALL多次CR患者自体SCT后3年DFS明显低于CR1患者。CBMTR已登记非血缘关系骨髓移植 5例 ,其中 2例死于复发 ,1例死于感染 ,目前仅存活 2例。结论 SCT应在患者白血病缓解最理想状态时进行。
Objective To investigate the application of hematopoietic stem cell transplantation (SCT) and measures to improve prognosis. Methods To summarize the nationally registered SCT case data received by the China Bone Marrow Transplant Registry (CBMTR) at the end of August 998, and to statistically analyze the patients’ long-term survival and recurrence rates. Results So far, 68 units in China have carried out SCT, of which 30 units have carried out allogeneic SCT. By the end of August 998, there were 184 patients with SCT registered in the country, of which 3,6% were allogeneic, 59.0 % were autologous SCT, and 9 were allogeneic. Statistics from 1 979 to 1 998 indicate that the disease-free survival rate (DFS) was 3 years after allogeneic SCT: 70.0% of patients with acute myeloid leukemia (AML) stage 1 complete remission (CR1) were acute lymph nodes. The rate of CR1 in patients with cell leukemia (ALL) was 48.2%, and that of patients with chronic myeloid leukemia in the first chronic phase (CP1) was 64.2%. AMLCR1 and multiple CR patients have similar efficacy after autologous transplantation, and patients with multiple CR have a significantly lower DFS than patients with CR1 three years after autologous SCT. CBMTR has registered 5 cases of non-myeloablative bone marrow transplantation, of which 2 died of relapse and 1 died of infection. At present, only 2 cases survived. Conclusions SCT should be performed when the patient’s leukemia is in the best state of remission.