中国当代儿科杂志2013，Vol.15Issue(1)：19-24,6.DOI:10.7499/j.issn.1008-8830.2013.01.006
异基因造血干细胞移植治疗儿童慢性粒细胞性白血病的疗效分析
Therapeutic efficacy of allogeneic hematopoietic stem cell transplantation in children with chronic myelogenous leukemia
江华 1胡文婷 1陈静 1罗长缨 1王坚敏 1周敏 1叶启东 1汤燕静 1罗成娟1
作者信息
- 1. 上海交通大学医学院附属上海儿童医学中心血液肿瘤科,上海200127
- 折叠
摘要
Abstract
Objective To investigate the therapeutic efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with chronic myelogenous leukemia (CML), and to analyze the possible prognostic factors. Methods The clinical data of 20 children with CML who had received allo-HSCT was analyzed retrospectively to investigate possible prognostic factors, including age, sex, interval between diagnosis and transplantation, HLA matching between donors and recipients, illness status on transplantation and acute and chronic graft-versus-host disease (GVHD). Results At the end of follow-up, 13 of the 20 treated children had disease-free survival (DFS) and the rest (7 cases) died. Four died of severe acute GVHD, two of chronic GVHD and its complications, and one of relapse after transplantation. The three-year DFS was (64.6±1.1%). As shown by the univariate analysis, age was the most important prognostic factor in children with CML who had received allo-HSCT (P<0. 05) , and in children over 10 years, the prognosis was poor. No other of the above factors had a significant impact on prognosis ( P > 0. 05). The multivariate logistic regression analysis also confirmed age as the only prognostic factor (P <0. 01). Severe acute and/or chronic GVHD was the most important cause of patient death. 10/10 HLA-matched donors could improve the transplantation outcome. Conclusions Allo-HSCT is an effective treatment for children with CML. To improve the prognosis and treatment outcome, children with CML aged over 10 years should receive allo-HSCT as early as possible. 10/10 HLA-matched donors are preferred in allo-HSCT and GVHD should be prevented.关键词
慢性粒细胞性白血病/异基因造血干细胞移植/移植物抗宿主病/儿童Key words
Chronic myelogenous leukemia/ Allogeneic hematopoietic stem cell transplantation/ Graft-versus-host disease/ Child引用本文复制引用
江华,胡文婷,陈静,罗长缨,王坚敏,周敏,叶启东,汤燕静,罗成娟..异基因造血干细胞移植治疗儿童慢性粒细胞性白血病的疗效分析[J].中国当代儿科杂志,2013,15(1):19-24,6.
