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目的:观察异基因造血干细胞移植治疗bcr/abl融合基因阳性急性白血病的临床疗效。方法:对MICM分型确诊的18例bcr/abl融合基因阳性急性白血病患者,采用化疗或加用酪氨酸激酶抑制剂达完全缓解后行异基因造血干细胞移植术。结果:18例行异基因造血干细胞移植术后,均获得造血及免疫功能重建。9例无病存活;1例复发,经治疗后再次达完全缓解;8例死亡,其中因复发死亡3例,移植相关死亡5例。2a无病生存率为(31.6±14.0)%,2a总生存率为(48.0±13.9)%;中位无病生存时间(9.0±3.1)个月,中位总生存时间(18.0±8.0)个月。结论:异基因造血干细胞移植是目前治愈bcr/abl融合基因阳性急性白血病的惟一有效手段,联合酪氨酸激酶抑制剂能有效提高长期生存率。
Objective: To observe the clinical efficacy of allogeneic hematopoietic stem cell transplantation in the treatment of bcr / abl fusion gene positive acute leukemia. Methods: Eighteen patients with positive bcr / abl fusion gene positive acute leukemia diagnosed by MICM were treated with chemotherapy or tyrosine kinase inhibitor and allogeneic hematopoietic stem cell transplantation was performed. Results: After allogeneic hematopoietic stem cell transplantation was performed in 18 cases, hematopoiesis and immune function were reconstructed. Nine patients survived without disease. One patient relapsed and achieved complete remission after treatment. Eight patients died, of which 3 died of recurrence and 5 died of transplantation. 2a had a disease-free survival rate of (31.6 ± 14.0)% and a total 2a survival rate of (48.0 ± 13.9)%, a median disease-free survival time of 9.0 ± 3.1 months and a median overall survival time of 18.0 ± 8.0 month. Conclusion: Allogeneic hematopoietic stem cell transplantation is the only effective way to cure bcr / abl fusion gene positive acute leukemia. Combined with tyrosine kinase inhibitors can effectively improve the long-term survival rate.