摘要
目的观察MCC和BuCy预处理方案治疗慢性髓性白血病(CML)移植后的长期疗效和毒副反应。方法采用MCC方案(马法兰170mg/m2·d×1,环已亚硝脲400mg/m2·d×1,环磷酰胺60mg/kg·d×2)预处理治疗CML14例,中位随访时间6年;采用BuCy方案(马利兰4mg/kg·d×4,环磷酰胺60mg/kg·d×2)预处理治疗CML16例,中位随访时间4年。结果30例病人全部植活,MCC组+100d移植嵌合状态高于BuCy组,但移植后2年全部均转为完全供者植入,bcr-abl融合基因检测阴性。MCC组移植相关死亡3例(21%),复发死亡1例(7%),5年无病存活率71.4%;BuCy组移植相关死亡4例(25%),复发死亡2例(12%),5年无病存活率62.5%。两组生存率比较差异无统计学意义(P>0.05)。MCC组移植相关毒性和肝静脉闭塞病的发生较BuCy组低,中位住院时间MCC组39d,BuCy组55d,差异有统计学意义(P<0.05)。结论低强度MCC预处理方案的长期疗效与传统BuCy方案相似,但移植相关毒性较低。在卫生经济学方面MCC预处理方案具有优势。
Objective To observe and evaluate the long term survival of patients with chronic myelocytic leukemia transplanted with MCC and BuCy conditioning regimens. Methods Fourteen cases were treated with MCC regimen（Melphanlan 170 mg/m^2·d×1,MeCCNU 400 mg/m^2·d×1,CTX 60 mg/kg·d× 2） and the median follow up time was 6 years, 16 cases were treated with BuCy regimen（Busulfan 4 mg/kg ·d× 4,CTX 60 mg/kg ·d× 2） and the median follow up time was 4 year. Results All the patients were engrafted successfully. 4 of 10 patients examined in MCC group showed mixed chimerism at day 100 after transplantation, whereas only 1 of 12 patients examined in BuCy group showed mixed chimerism. All the patients became complete donor source later without any DLI. The 5-year disease-free survival rate was 71.4% for MCC group and 62. 5% for BuCy group. The transplant related mortality and relapse rate were 210% and 7% for MCC group, whereas those were 25% and 12% for BuCy group, respectively. The regimen related toxicity was relatively lower in MCC group and the median duration of hospitalization was 39 days （25-55 days） for patients with MCC regimen, and 55 days （39-90 days）for BuCy regimen. Conclusion MCC regimen has a partial ablative effect on CML and the long term diseasefree survival is the same as that of BuCy regimen. In regard to the cost-effect efficacy, MCC regimen has a substantial advantage over BuCy regimen.
出处
《四川大学学报（医学版）》
CAS
CSCD
北大核心
2006年第2期226-229,共4页
Journal of Sichuan University(Medical Sciences)
