| Objective:To compare the related factors of hematopoietic reconstitution and others in patients with acute myeloid leukemia?AML?treated by autologous peripheral blood stem cell transplantation?APBSCT?in our hospital who pretreated with FAC and CBVA,and to provide a basis for clinical selection of safer and more economical pretreatment schemes.Methods:Patients with Non-M3 acute myeloid leukemia who have completed autologous peripheral blood stem cell transplantation in the hematology department of our hospital?from January 2007 to December 2018?were included in this study,the subjects were grouped according to the pretreatment scheme:group A was FAC group,Group B was CBVA group.Group A:fludarabine?Flu?+cytarabine?Ara-C?+cyclophosphamide?CTX?,a total of 9 cases.Group B:cyclophosphamide?CTX?+carmustine?BCNU?+etoposide?Vp16?+cytarabine?Ara-C?,a total of 7 cases.The peripheral blood images,hematopoietic reconstruction time,component blood transfusion volume and cost,antibiotic use time and cost,adverse reaction of pretreatment,cytokine use time and cost,laminar flow ward time and total hospitalization cost of the two groups of patients after pretreatment were compared and analyzed.SPSS20.0 statistical software was used to analysis the data.Independent sample t test was used to compare the mean between the two groups.Nonparametric rank sum test was used for non-normal data.Fisher's exact probability method was used for counting data.Multivariate linear regression were used in multivariate analysis.P<0.05 was considered statistically significant.Results:1.After pretreatment,the low limit values of WBC?×109/L?,Hb?×g/L?and PLT?×109/L?in bone marrow depression period of the group A and B were resp--ectively:?0.08±0.02 vs 0.01±0.00?,?70.78±10.73 vs 55.00±13.96?,?10.22±4.12 vs 5.43±2.76?.There were differences in bone marrow depression between the two gr--oups after pretreatment?P<0.05?.The time of reaching the low limit of WBC,Hb and PLT in bone marrow depression was?11.11±1.36 vs 10.57±2.15?,?15.67±4.74 vs 24.86±10.30?,?14.00±4.09 vs 16.29±3.95?,?d?respectively,and there was no significant difference between the two groups?P>0.05?.2.The time of hematopoietic reconstitution of group A and group B:ANC?0.5×109/L was?11.33±2.65 vs 11.57±3.21??d?,PLT?20×109/L was?16.56±4.80 vs 21.57±11.41??d?,respectively.There has no significant difference between the two groups?P>0.05?.Multivariate linear stepwise regression analysis showed that the days of use of recombinant human granulocyte colony stimulating factor and th e time from diagnosis to transplantation had significant effects on the time of A NC?0.5×109/L after transplantation.The regression equation was:YANC?0.5×109/L=7.820+0.467X1-0.247X2.The days of G-CSF use and platelet transfusion had significan t effects on the time of PLT?20×109/L after transplantation.The regression equatio n was:YPLT?20×109/L=0.612X2+0.379X4.3.The RBC infusion volume and PLT infusion volume of the group A and B were?2.22±1.56 vs 3.71±3.14?,?U?and?7.93±2.94 vs 8.11±3.02?,?personnel?respectively,and the blood transfusion cost was?11110.56±3363.93 vs 11484.43±4754.53?,?RMB?,respectively,with no significant difference?P>0.05?.4.The time of restrictive antibiotic use in group A and group B was?12.78±9.60vs 14.00±9.45??d?,the time of fever with agranulocytosis was?5.89±4.60?vs?6.29±3.73??d?,and the total cost of antibiotics was[3881.13?3246.996220.99?vs 4598.48?3789.247892.43?]?RMB?,respectively,with no significant difference?P>0.05?.5.Adverse reactions after pretreatment in two groups:In group A,all 9 patients had agranulocytosis and fever,and 6 out of 7 patients had agranulocytosis and fever in group B.In group A,8 patients had nausea and vomiting,and all 5 patients had nausea and vomiting in group B.Oral mucositis occurred in 1 patient in group A and 2 patients in group B.In group A,2 patients had myocardial damage and 1 patient had diarrhea and 3 patients had hepatosis,and 2 patients had diarrhea in group B.However,there were no significant difference between the two groups?P>0.05?.6.The usage time of G-CSF after transplantation in group A and group B was?12.56±4.45 vs 17.14±6.15??d?,the usage time of recombinant human interle ukin-11?IL-11?was[2.00?0.0015.00?vs 10.00?0.0014.00?]?d?,and the cost of cytokine was?7712.17±5993.66 vs 8709.86±3622.02??RMB?,the difference be tween the two groups has no statistically significant?P>0.05?.7.The time of WBC?1.0×109/L in group A and group B was?10.67±2.12 vs11.43±2.88??d?,respectively.The time of PLT?50×109/L was?19.56±5.41 vs29.14±13.63??d?,the time of leaving laminar flow ward was?13.67±3.32 vs14.71±4.39??d?,and the total hospitalization expenses were?105213.71±36970.93 vs107731.44±29254.05??RMB?,respectively,has no significant difference?P>0.05?.Conclusion:1.When AML patients underwent APBSCT,the time of hematopoietic reconstitution between FAC and CBVA pretreatment regimen is comparable;2.The safety and economics of the FAC and CBVA pretreatment regimen are similar when AML patients underwent APBSCT. |
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