成人急性淋巴细胞白血病自体和异基因造血干细胞移植疗效对比分析

OBJECTVE: To compare the outcomes of adult patients with acute lymphoblastic leukemia (ALL) who underwent autologous hematopoietic stem cell transplantation (auto-HSCT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: From Jan 2007 to Dec 2010, 106 adult ALL patients were retrospectively divided into two groups, 50 in auto-HSCT group and 56 in allo-HSCT group. Auto-HSCT group included 21 patients with high-risk, 46 patients in CR(1) and 4 cases in CR(2). All the 50 patients had negative minimal residual disease (MRD) prior to HSCT. Allo-HSCT group included 44 patients with high risk, 51 patients in CR(1) and 5 cases in CR(2), 14 patients with positive MRD before allo-HSCT. RESULTS: Of the total 106 patients, 29 patients relapsed at a medium follow-up of 22.9(0.8–63.3) months. The 3-year cumulative relapse rate (RR) was (29.9±8.0)% in auto-HSCT group and (32.7±6.8)% in allo-HSCT group. There were no significant differences in RR and overall survival (OS) between auto-HSCT and allo-HSCT groups, even of stratified risk groups. In standard risk group, 3-year OS was (77.1±13.2)% in auto-HSCT group and (90.9±8.7)% in allo-HSCT group (P=0.739). In high-risk group, 3-year OS was (68.7±10.8)% after auto-HSCT and (45.2±8.5)% after allo-HSCT (P=0.094). CONCLUSION: Due to acceptable RR and OS, adult ALL patients with no MRD before HSCT showed favorable survival. Auto-HSCT may be a considerable choice for adult ALL patients with negative MRD when lacking of donors for allo-HSCT.