异基因外周血干细胞移植治疗白血病27例.doc

异基因外周血干细胞移植治疗白血病27例.doc异基因外周血干细胞移植治疗白血病27例
作者:白庆咸,陈协群,王文清,董宝侠,李蕊,石梅,李琳
【Abstract】AIM: To observe the efficacy and main plications of allogenEic peripheral blood stem cell transplantation(alloPBSCT) in 27 patients ia. METHODS: Tia patients including 10 acute myeloid leukemia (AML), 8 acute lymphocytic leukemia (ALL) and 9 chronic myelogenous leukemia (CML) recEIved allo-PBSCT from HLAidentical sibling (n = 25)and 1~2 locus mismatched sibling(n = 2). Conditioning regimen consisted of cyclophosphamide and total body irradiation plus Arac/VP16(n=13) or busulphancyclophosphamide(n = 14). Graft versus-host disease (GVHD) prophylaxis ethotrexate and cyclosporine bination. ATG and CD25 monoclonal antibody ismatched alloPBSCT. RESULTS: Tent. ⅡⅢ degree acute GVHD and chronic GVHD onia syndrome occurred in 1 case. Pure red cell aplasia lasted for 8 months in one patient ajor ABO and Rh inpatible PBSCT. L)10例, 急性淋巴细胞白血病(ALL) 8例,慢性髓细胞白血病(CML) , 1~(CYTBI)为主的预处理方案或白消安联合环磷酰胺(BuCY2 )(CsA)联合短期甲氨蝶呤(MTX)预防移植物抗宿主病(GVHD).2个HLA主要位点不合的1例移植患者加用兔抗人胸腺球蛋白(ATG): 全部患者均获得稳定植入,ⅡⅢ度急性GVHD 3例(11%),慢性GVHD ~30 mo,存活20例(74%),移植后4~11 mo死于白血病复发7 例(26%). 结论: 异基因外周血干细胞移植是治疗白血病的有效方法,但移植前处于高危难治状态的病例复发率仍较高.
【关键词】白血病; 外周血干细胞移植;异基因
0引言
外周血干细胞的发现,使异基因外周血干细胞移植(allogeneic peripheral heamatopoietic stem cell t