不同异基因造血干细胞移植方式治疗167例中高危骨髓增生异常综合征疗效比较

OBJECTIVE: To investigate three different types of donor hematopoietic stem cell transplantation (HSCT) for intermediate and high-risk myelodysplastic syndrome (MDS). METHODS: Between August 2001 and May 2015, 167 consecutive patients with MDS in intermediate and high-risk who underwent allogeneic HSCT were analyzed retrospectively. RESULTS: With the median follow up of 60 (12–177) months, The total 5-year DFS was 67.8% (95%CI 60.0%–75.6%). Among three different types of donor, 5-year DFS rates were 68.0% (95%CI 54.1%–81.9%) in MSD-HSCT vs 77.4% (95%CI 62.1%–92.7%) in MUD-HSCT vs 64.0% (95% CI 52.4%–75.6%) in Haplo-HSCT (P=0.632), respectively. Univariate analysis showed that median disease course before HSCT was the influencing factor of DFS (P=0.018). Five-year relapse and TRM had no correlation with the above-mentioned factor. CONCLUSION: Haplo-HSCT for intermediate and high-risk MDS achieved similar effect produced by MUD or MSD, Haplo-HSCT could be used as an important alternative donor. allo-HSCT must be performed on intermediate and high-risk MDS patients as early as possible after diagnosis.