阿扎胞苷用于急性白血病异基因造血干细胞移植后维持治疗的疗效分析
Efficacy Analysis of Azacitidine as Maintenance Therapy Following Allogeneic Hematopoietic Stem Cell Transplantation in Acute Leukemia
摘要: 目的：探讨阿扎胞苷(AZA)在急性白血病异基因造血干细胞移植(allo-HSCT)后维持治疗的临床疗效及安全性。方法：对2018年1月至2023年12月期间，于安徽医科大学第一附属医院血液内科接受allo-HSCT的患者临床资料进行回顾性分析。其中33例急性白血病患者在allo-HSCT后采用含AZA的方案进行维持治疗；同期有30例急性白血病患者未进行维持治疗。观察两组患者移植后移植物抗宿主病(GVHD)的发生情况，运用Kaplan-Meier法计算总体生存率(OS)、无白血病生存率(LFS)，以此评估含AZA维持治疗方案的疗效及安全性。结果：随访至2024年12月1日，维持治疗组的终点OS率(90.9% vs. 70.0%)和LFS率(81.8% vs. 50.0%)均明显高于对照组，OS和LFS分别显著延长(43.4 ± 1.9 vs. 26.2 ± 2.6个月，p = 0.01；40.0 ± 2.5 vs. 20.3 ± 2.8个月，p = 0.0004)。GVHD发生率方面，两组在急性GVHD (27.3% vs. 36.7%, p = 0.589)和慢性GVHD (31.7% vs. 33.3%, p = 1.000)上无显著差异，表明AZA维持治疗未增加GVHD风险。结论：应用含AZA方案进行allo-HSCT后维持治疗可显著提高移植后急性白血病患者的OS和LFS，且不增加GVHD风险。
Abstract: Objective: Clinical Efficacy and Safety of Azacitidine (AZA) as Post-Transplant Maintenance Therapy in Acute Leukemia Following Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT). Methods: A retrospective analysis was conducted on clinical data from patients who underwent allo-HSCT for acute leukemia in the Department of Hematology at the First Affiliated Hospital of Anhui Medical University between January 2018 and December 2023. Thirty-three patients received AZA-based maintenance therapy post-transplant, while 30 patients served as controls without maintenance. Outcomes including graft-versus-host disease (GVHD) incidence, overall survival (OS), and leukemia-free survival (LFS) were evaluated using Kaplan-Meier analysis. Results: By December 1, 2024, the AZA maintenance group demonstrated significantly higher OS (90.9% vs. 70.0%, p = 0.01) and LFS (81.8% vs. 50.0%, p = 0.0004) compared to controls, with prolonged median OS (43.4 ± 1.9 vs. 26.2 ± 2.6 months) and LFS (40.0 ± 2.5 vs. 20.3 ± 2.8 months). No significant differences were observed in acute GVHD (27.3% vs. 36.7%, p = 0.589) or chronic GVHD (31.7% vs. 33.3%, p = 1.000), indicating AZA did not increase GVHD risk. Conclusion: AZA-based maintenance therapy post-allo-HSCT significantly improves OS and LFS in acute leukemia patients without elevating GVHD incidence.
文章引用：唐保玉, 李庆生. 阿扎胞苷用于急性白血病异基因造血干细胞移植后维持治疗的疗效分析[J]. 临床医学进展, 2025, 15(4): 3376-3382. https://doi.org/10.12677/acm.2025.1541308

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