造血干细胞移植治疗老年髓系肿瘤的临床分析

Clinical analysis of hematopoietic stem cell transplantation for the treatment of elderly myeloid tumors

  • 摘要:
    目的 探讨造血干细胞移植(hematopoietic stem cell transplantation,HSCT)对老年髓系肿瘤患者生存结局的影响。
    方法 回顾性分析2018年1月至2023年5月于南方医科大学附属珠江医院54例接受HSCT且年龄≥55岁髓系肿瘤患者的治疗结局。
    结果 54例患者中急性髓系白血病(acute myeloid leukemia,AML)患者45例,骨髓增生异常综合征患者9例,中位年龄57.5(55.0~68.0)岁。53例成功造血重建,中性粒细胞植入中位时间为13(8~24)天,血小板植入中位时间为15(9~75)天。急性移植物抗宿主病(graft-versus-host diseas,GVHD)累积发生率23.3%,3年慢性GVHD累积发生率24.6%。中位随访时间28.2个月,3年累积复发率(cumulative relapse rates,CIR)18.0%,3年非复发死亡率28.3%。3年无复发生存(relapse-free survival,RFS)率为58.2%,3年总生存(overall survival,OS)率为56.5%。
    结论 HSCT是老年髓系肿瘤患者获得长期生存的有效、安全的治疗手段。

     

    Abstract:
    Objective To investigate the effect of hematopoietic stem cell transplantationon (HSCT) survival outcomes in older patients with myeloid neoplasms.
    Methods We retrospectively analyzed the treatment outcomes of 54 patients aged ≥55 years with myeloid neoplasms who underwent HSCT between January 2018 and May 2023 at Zhujiang Hospital of Southern Medical University.
    Results Among the 54 patients, 45 had acute myeloid leukemia (AML) and 9 had myelodysplastic syndrome. The median age of the patients was 57.5 (55-68) years. Fifty-three patients underwent hematopoietic reconstitution, with a median time to neutrophil reconstitution of 13 (8-24) days and median time to platelet reconstitution of 15 (9-75) days. The cumulative incidence was 23.3% for acute graft-versus-host disease (GVHD) and 24.6% for 3-year chronic GVHD. With a median follow-up of 28.2 months, the 3-year cumulative relapse rate (CIR) was 18% and 3-year non-relapse mortality rate was 28.3%. The 3-year relapse-free survival (RFS) rate was 58.2% and 3-year overall survival (OS) rate was 56.5%.
    Conclusions HSCT is an effective and safe therapy for achieving long-term survival in older patients with myeloid tumors.

     

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