单倍型造血干细胞移植治疗伴骨髓增生异常综合征相关特征急性髓系白血病临床分析

OBJECTIVE: To investigate the prognosis of haploidentical hematopoietic stem cell transplantation (haplo-HSCT) in the treatment of acute myeloid leukemia with myelodysplasia-related changes (AML-MRC). METHODS: The data of 102 patients with high-risk AML in the first complete remission phase (CR1) who received haplo-HSCT from January 2009 to July 2015 in Peking University People's Hospital were retrospectively analyzed. RESULTS: These 102 cases included 17 AML-MRC cases (AML-MRC group) and 85 other types of AML cases (control group). There were 8 males and 9 females in the AML-MRC group, and the median age was 35 (17–61) years. There were 52 males and 33 females in other high-risk AML group, and the median age was 31 (11–60) years. No difference was observed between the two groups after haploidentical stem cell transplantation in the rates of cytomegalovirus, EBV (Epstein-Barr virus), blood flow infection rate and hematopoietic reconstitution (P>0.05). The overall 2-year survival rate after transplantation was 80.8% (95%CI 51.6%–93.4%) and 72.5% (95%CI 62.8%–80.1%) (P=0.650), the disease-free survival rate was 79.4% (95%CI 48.8%–92.9%) and 65.9% (95%CI 54.3%–75.2%) (P=0.573), cumulative recurrence rate was 13.0%(95%CI 1.9%–34.7%) and 13.3%(95%CI 7.0%–21.5%) (P=0.623), and non-relapse mortality was 6.7% (95%CI 0.3%–27.0%) and 20.0% (95%CI 12.0%–29.4%) (P=0.436). CONCLUSION: The prognosis of haplo-HSCT in patients with AML-MRC in CR(1) is similar to that of other types of high-risk AML patients. Haplo-HSCT is an ideal choice for patients with AML-MRC in CR(1).