外周血干细胞移植治疗11例急性白血病和恶性实体瘤  

Peripheral blood stem cell transplantation for the treatment of 11 cases with acute leukemia and malignant solid tumors

作　　者：崔杰[1] 古扎努[1] 王菊勇[1] 张毓升[1] 刘喜婷[1] 姜俊峰[1] 李文英[1] 余兰平[1] 马兰芳[1] 李睦昭[1] 

机构地区：[1]甘肃省肿瘤医院血液科,甘肃兰州730050

出　　处：《中国癌症杂志》2005年第2期138-140,共3页China Oncology

基　　金：甘肃省科技厅攻关项目资助(No:GS022A43118)。

摘　　要：目的:观察外周血干细胞移植(PBSCT)治疗急性白血病和恶性实体瘤的临床疗效观察。方法:自1999年11月至2004年3月,用PBSCT治疗急性白血病和恶性实体瘤11例,其中:急性淋巴细胞白血病(ALL)1例;急性非淋巴细胞白血病(ANLL)3例;非霍奇金淋巴瘤(NHL)4例;霍奇金淋巴瘤(HD)1例;乳腺癌1例;恶性黑色素瘤1例。除1例异基因外周血干细胞移植患者采用重组人粒细胞集落刺激因子(rhGCSF,惠尔血)对供者进行动员外,其他患者均为自体外周血干细胞移植,动员方案为化疗+rhGCSF。经2次采集,获得MNC为(5.91±2.34)×108/kg,CD34+细胞为(14.05±6.65)×106/kg,CFUGM(4.80±2.80)×105/kg。预处理方案3例患者采用FTBI加化疗,8例患者采用高剂量化疗方案。结果:所有患者移植后均重建造血。外周血WBC于移植后(6±1)天降至0。PLT于(7±1)天降至30×109/L以下。WBC>1.0×109/L、中性粒细胞>0.5×109/L、PLT>50×109/L,分别为(11±2)天、(11±2)天、(13±3)天。3例患者于移植后1～12个月死于肝功能衰竭或病情复发,2例患者带瘤生存3～5个月,其余患者均无瘤存活3～46个月,疗效仍在近一步随访中。结论:PBSCT对急性白血病和恶性实体瘤是一种安全有效的治疗方法。Purpose:To evaluate the therapectic effects of peripheral blood stem cell transplantation (PBSCT) on the treatment of acute leukemia and malignant solid tumors. Methods:Eleven patients with acute leukemia and malignant solid tumors were treated by PBSCT from December 1999 to March 2004. One of them was ALL-L_(2), 1ANLL-M_(1), 1ANLL-M_(3),1ANLL-M_(5b), 4NHL,1HD,1breast cancer,1malignant melanoma. In one patient who received allogeneic PBSCT, the donor received rhG-CSF at a dose of 10ug/kg/d by subcutaneous injection for 5d for PBSCT mobilization. Other patients received autologous PBSCT (APBSCT) combined with chemotherapy regimen followed by rhG-CSF. PBSCT were collected in two phases for mononuclear cell (MNC) of (5.91±2.34)×10^(8)/kg.,CD_(34) ^(+) cell (14.05±6.65)×10^(6)/kg.,and CFU-GM ((4.80)±2.80)×10^(5)/kg. Three patients received FTBI+CTX±Ara-c,8 patients high-dose chemotherapy (CTX,Vp-16,Ara-c,DTIC,BCNU〕as conditioning regimen respectively. Results:All patients were grafted and hematopoietic reconstitution was rapid. (6±1) days after transplantation,WBC was 0×10^(9)/L; (7±1) days after transplantation,PLT was below to <30×10^(9)/L.The days of WBC recovery were (11±2) days up to >1.0×10^(9)/L,ANC (11±2) days up to >0.5×10^(9)/L and PLT (13±3) days up to >50×10^(9)/L. Of the patients, 3 died of liver function exhaustion or disease relapse 1-12 months after transplantation , 2 are still alive with disease for 3-5 months , but others are still alive and disease-free for 3-64 months. Conclusions:PBSCT is a safe therapeutic option that can significantly improve in acute leukemia and malignant solid tumors.

关 键 词：白血病 恶性实体瘤 外周血干细胞移植 

分 类 号：R733.71[医药卫生—肿瘤] R617[医药卫生—临床医学]