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目的 了解α干扰素 (IFN α)对慢性髓系白血病 (CML)患者异基因骨髓移植 (allo BMT)预后的影响。方法 分析总结 1993年 3月～ 1999年底行allo BMT的CML第 1次慢性期 (CP1 )患者 85例。BMT前未用IFN α治疗组 3 0例 ,用IFN α治疗 5 5例 ;其中疗程 <6个月 3 0例 ,6～ 12个月 15例 ,>12个月 10例。结果 经COX多元回归分析 ,患者年龄、性别、确诊至BMT的时间、预处理方案、停IFN距BMT时间对生存率无影响 ,而用IFN治疗的疗程与生存率有关 ;4组的植活时间、Ⅱ～Ⅳ度急性移植物抗宿主病 (GVHD)、慢性GVHD、肝静脉闭塞症、白血病复发的发生率及非白血病死亡率差异均无显著性。IFN α用药≥ 6个月组Ⅲ～Ⅳ度GVHD发生率比其它两组明显升高 (P <0 .0 1)。与不用IFN α组及用药 >12个月组比较 ,IFN α用药 <6个月组 5年生存率高 (P <0 .0 5 ) ,而与用药 6～ 12个月组相比 ,IFN α疗程 <6个月组 5年生存率也高 ,但差异无统计学意义。结论 用IFN α治疗半年以内 ,5年生存率有提高的趋势 ,应用半年以上有可能使Ⅲ～Ⅳ度GVHD发生率增加 ,但应用 1年以内 ,对生存率没有造成不良影响。IFN对CMLallo BMT预后的影响尚须更多资料进一步证实。
Objective To investigate the effect of interferon alpha (IFN alpha) on the prognosis of allogeneic bone marrow transplantation (allo BMT) in patients with chronic myeloid leukemia (CML). METHODS: Eighty-five patients with CML first chronic phase (CP1) who underwent allo BMT from March 1993 to the end of 1999 were analyzed. 30 patients without IFNα before BMT were treated with IFNα, and 55 patients were treated with IFNα for 30 months, 6 months for 12 months, and 10 patients for 12 months. Results After COX multiple regression analysis, the patient’s age, gender, time to diagnosis of BMT, pretreatment regimen, and time of cessation of IFN-BMT had no effect on the survival rate, whereas the course of treatment with IFN was related to survival rate; the time of engraftment of group 4 was There was no significant difference in the incidence of acute graft-versus-host disease (GVHD), chronic GVHD, hepatic venous occlusion, leukemia recurrence, and non-leukemia mortality. The incidence of GVHD at III-IV was significantly higher in patients treated with IFNα for 6 months than in those in other groups (P < 0.01). Compared with the group without IFNα and the group with >12 months of medication, the 5-year survival rate of IFN α group at the 6-month group was higher (P < 0.05), compared with 6 to 12 months group, IFN α The 5-year survival rate was also higher in the 6-month treatment group, but the difference was not statistically significant. Conclusions The 5-year survival rate of patients treated with IFN alpha within half a year has an increasing trend. The use of more than half a year may increase the incidence of III-IV GVHD. However, within one year of use, there is no adverse effect on the survival rate. The effect of IFN on the prognosis of CMLallo BMT still needs more data to further confirm.