关键词: 轻链型淀粉样变性, 外周血造血干细胞移植, 造血重建

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To ananlysis factors that influence hematopoietic recovery after autologous peripheral blood stem cell transplantation (APBSCT) for patients with light chain (AL) amyloidosis.
Ｍｅｔｈｏｄｏｌｏｇｙ：211 AL amyloidosis patients who underwent APBSCT in our hospital from July 2010 to June 2018 were included. We retrospectively analysis the baseline characteristics,factors related to the stem cell collection and transplantation process. COX univariate and multivariate regression,logistic regression were used to analysis influencing factors of hematopoietic reconstitution after APBSCT.
Ｒｅｓｕｌｔｓ：All patients achieved neutrophil engraftment and the median time to engraftment was 10 (range,8～22) days. COX multivariate analysis showed that pretreatment with highdose melphalan,a hematologic response better than partial relief before transplantation were associated with a rapid neutrophil engraftment. 209 patients achieved platelet engraftment within 100 days of transplantation,and the median time to platelet engraftment was 11 (range,8～31) days. COX multivariate analysis showed that pretreatment with highdose melphalan was related to a higher probability of rapid platelet engraftment. Logistic analysis showed that collecting stem cells>84×106 cells/kg,pretreatment with highdose melphalan may have a positive effect to engraftment,however leukocyte before transplantation less than 40×109/L may be opposite.
Ｃｏｎｃｌｕｓｉｏｎ：CD34+ cells,melphalan dose for pretreatment,and pretransplant hematologic response status were important factors influencing hematological reconstruction after APBSCT in AL patients.

Key words: light chain amyloidosis, autologous peripheral blood stem cell transplantation, hematopoietic recovery