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目的:探讨急性髓系白血病(AML)患者行异基因造血干细胞移植(allo-HSCT)治疗的预后相关因素。方法:对本院60例行allo-HSCT的AML患者的临床资料行回顾性分析,并引入COX风险比例模型,探讨影响这部分患者生存与复发的预后因素。结果:患者高龄(HR=4.530,P=0.012)、慢性移植物抗宿主病(c GVHD)(HR=0.023,P=0.003)及侵袭性真菌病(IFD)(HR=4.019,P=0.017)是影响AM L患者造血干细胞移植术后2年累积总生存率(OS)的独立因素;患者移植前高危状态(HR=3.465,P=0.028)、预处理方案(TBI/Cy vs Bu/Cy:HR=0.071,P=0.012,FB vs Bu/Cy:HR=7.547,P=0.025)及c GVHD(HR=0.088,P=0.004)是影响AM L患者造血干细胞移植术后2年累积复发率(RR)的独立因素。c GVHD(P=0.017)及IFD(P=0.000)是影响存活超过2年移植患者OS的重要因素。结论:患者高龄、移植前缓解状态、预处理方案、c GVHD及IFD与移植后AML预后密切相关,对于不同患者需行个体化治疗。
Objective: To investigate the prognostic factors of allo-HSCT in patients with acute myeloid leukemia (AML). Methods: The clinical data of 60 AML patients undergoing allo-HSCT in our hospital were retrospectively analyzed. The COX risk proportional model was introduced to investigate the prognostic factors that affect the survival and recurrence of this patient. Results: The age of the patients (HR = 4.530, P = 0.012), chronic graft versus host disease (HRV = 0.023, P = 0.003) and invasive fungal disease (IFD) Is an independent factor influencing the 2-year cumulative overall survival (OS) after AMH transplantation in patients with AML. The pre-transplant high-risk patients (HR = 3.465, P = 0.028) HR = 0.071, P = 0.012, FB vs Bu / Cy: HR = 7.547, P = 0.025) and cGVHD (HR = 0.088, P = 0.004) were the two year cumulative recurrence rates of AML patients after hematopoietic stem cell transplantation RR) independent factor. c GVHD (P = 0.017) and IFD (P = 0.000) were the important factors influencing the OS of transplant patients survived more than 2 years. CONCLUSION: The elderly patients, the status of pre-transplantation remission, pretreatment regimen, c GVHD and IFD are closely related to the prognosis of AML after transplantation. Individualized treatment is needed for different patients.