Autologous peripheral blood stem cell transplantation with granulocyte colony-stimulating factor combined conditioning regimen as a postremission therapy for acute myelogenous leukemia in first complete remission
Autologous peripheral blood stem cell transplantation with granulocyte colony-stimulating factor combined conditioning regimen as a postremission therapy for acute myelogenous leukemia in first complete remission
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自体外周血干细胞移植联合粒细胞集落刺激因子联合预处理方案治疗首次完全缓解的急性髓系白血病
DOI：
10.1007/s12185-013-1378-9
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发表时间：
2013
期刊：
影响因子：
2.1
通讯作者：
Harada M
中科院分区：
文献类型：
--
作者：
Eto T;Takase K;Miyamoto T;Ohno Y;Kamimura T;Nagafuji K;Takamatsu Y;Teshima T;Gondo H;Taniguchi S;Akashi K;Harada M
我们回顾性分析了1989年至2005年期间福冈血液和骨髓移植组接受大剂量化疗（HDCT）和自体外周血干细胞移植（Auto-PBSCT）治疗的81例首次完全缓解（CR 1）的非M3急性髓细胞性白血病（AML）患者的结局。根据西南肿瘤组的标准，细胞遗传学上，16例患者被定义为良好风险，56例为中度风险，9例为不良风险。移植前预处理方案包括大剂量白消安、足叶乙甙和阿糖胞苷（G-CSF方案），联合粒细胞集落刺激因子（G-CSF）预处理。Auto-PBSCT后中位随访时间为103个月（范围3-240个月）时，5年无病生存期（DFS）和总生存期分别为64.0%（95%CI 52.5-73.4）和66.4%（95%CI 54.9-75.6）。2例患者在Auto-PBSCT后6个月死于移植相关肺部并发症，无复发。遗传学良好、中等和低风险组患者的5年DFS率分别为80.8%、64.3%和33.3%，但风险组之间无统计学差异（log-rankp= 0.0579）。这些观察结果表明，HDCT支持下的Auto-PBSCT联合G-CSF预充方案是CR 1 AML缓解后治疗的一种治疗选择。
We retrospectively analyzed the outcomes of 81 patients with non-M3 acute myelogenous leukemia (AML) in first complete remission (CR1) who were treated with high-dose chemotherapy (HDCT) and autologous peripheral blood stem cell transplantation (Auto-PBSCT) by the Fukuoka Blood and Marrow Transplantation Group between 1989 and 2005. Cytogenetically, 16 patients were defined as good risk, 56 as intermediate risk, and nine as poor risk, following the Southwest Oncology Group criteria. The pre-transplant conditioning regimen consisted of high-dose busulfan, etoposide, and cytarabine (BEA regimen), combined with priming by granulocyte colony-stimulating factor (G-CSF). Disease-free survival (DFS) and overall survival at 5 years were 64.0 % (95 % CI 52.5–73.4) and 66.4 % (95 % CI 54.9–75.6) after Auto-PBSCT at a median follow-up time of 103 months (range 3–240 months), respectively. Two patients died of transplant-related pulmonary complications 6 months after Auto-PBSCT without relapse. The 5-year DFS rates of patients in the genetically good-, intermediate-, and poor-risk groups were 80.8, 64.3, and 33.3 %, respectively, but there was no significant difference statistically among the risk groups (log-rankp= 0.0579). These observations suggest that HDCT supported by Auto-PBSCT with the BEA regimen combined with G-CSF priming is a therapeutic option for postremission therapy of AML in CR1.