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目的比较自体与异基因造血干细胞移植治疗成人急性淋巴细胞白血病的效果。方法选取2008年1月至2016年6月成人急性淋巴细胞白血病患者70例,其中40例患者实施异基因造血干细胞移植(对照组),移植后不予维持化疗;30例患者实施自体造血干细胞移植(观察组),并且移植后3个月开始进行维持化疗或靶向治疗,持续2~3年或直至复发。比较两组患者复发和生存情况。结果随访3年,两组累积复发率、复发时间、总体生存及无白血病生存率比较差异未见统计学意义(P>0.05)。结论异基因造血干细胞移植仍然是治疗成人急性淋巴细胞白血病的最优选择,但若患者移植前微小残留检查呈阴性且缺乏合适的供者,可以选择用自体造血干细胞移植代替。
Objective To compare the effects of autologous and allogeneic hematopoietic stem cell transplantation in the treatment of adult acute lymphoblastic leukemia. Methods Seventy patients with adult acute lymphoblastic leukemia from January 2008 to June 2016 were selected. Forty patients underwent allogeneic hematopoietic stem cell transplantation (control group) without chemotherapy after transplantation. Thirty patients underwent autologous hematopoietic stem cell transplantation (Observation group), and three months after transplantation, maintenance chemotherapy or targeted therapy continued for 2 ~ 3 years or until relapse. The recurrence and survival of the two groups were compared. The results were followed up for 3 years, the cumulative recurrence rate, recurrence time, overall survival and no leukemia survival rate was no significant difference (P> 0.05). Conclusion Allogeneic hematopoietic stem cell transplantation is still the best choice for the treatment of acute lymphoblastic leukemia in adults. However, if the patient has a negative residual micrometastase and a suitable donor is not available, hematopoietic stem cell transplantation may be used instead.