重组人IL-2联合-α干扰素激活自体骨髓移植治疗首次缓解期急性白血病24例临床研究  

Study on transplantation of autologous bone marrow activated with rIL- 2 and interferon- αin acute leukemia during first remission:report of 24 cases

作　　者：冯四洲[1] 韩俊领[1] 姜容[1] 赵英新[1] 王玫[1] 张乃红[1] 陈鲁宁[1] 王津雨[1] 张桂新[1] 刘庆国[1] 韩明哲[1] 

机构地区：[1]中国医学科学院中国协和医科大学血液学研究所血液病医院,天津300020

出　　处：《生物医学工程与临床》2005年第5期293-296,共4页Biomedical Engineering and Clinical Medicine

摘　　要：目的研究重组人白细胞介素2(IL-2)联合-α干扰素激活骨髓自体移植治疗首次缓解期急性白血病的疗效及造血重建能力。方法24例首次缓解期急性白血病患者,其中男9例,女15例,中位年龄26岁(9～40岁);急性淋巴细胞白血病(ALL)13例,急性非淋巴细胞白血病(ANLL)9例,急性杂合性白血病(AHL)2例。预处理方案包括单次全身照射(sTBI)10 Gy+环磷酰胺(Cy)60 mg/kg×2次12例,sTBI 7 Gy+Cy 60 mg/kg×2次+阿糖胞苷(Ara-C)2 g/(m2.d)×2次5例,sTBI 9 Gy+Cy 60 mg/kg×2次+鬼臼乙叉苷(VP-16)200 mg/d×2次或鬼臼毒素(VM-26)200 mg/d×2次4例,MAC方案(马法兰Mel 160 mg/m2+Ara-C1 g/m2 Q12 h×6次+Cy60 mg/kg×2次)3例。进行IL-2联合-α干扰素激活自体骨髓并移植,移植后观察患者造血重建、长期无病生存率、移植相关死亡率、复发率及严重的移植相关并发症。结果移植后除2例患者因严重感染早期死亡外,所有22例患者获得造血重建。移植相关死亡3例,6例复发,15例患者持续完全缓解90个月(79～102个月),5年无病生存率及复发率分别为62.5%±9.9%及27.3%±9.5%。结论IL-2联合-α干扰素激活自体骨髓移植是治疗首次缓解期急性白血病的一种有效手段。Objective To study the clinical effect on transplantation of autologous bone marrow activated with recombinant interleukin-2 （rIL-2） and interferon-α for patients in acute leukemia during the first complete remission （CR1） and the ability of hematopoietic reconstruction post-transplantation. Methods With study enrolled 24 patients with acute leukemia in CR1,15 females and 9 males, the median age of them were 26 （9 - 40） years old, including 13 patients with acute lymphoblastic leukemia （ALL） and 9 with acute non-lympoblastic leukemia（ANLL） and 2 with acute mixed.leukemia（AHL）. The conditioning regimens included Cy 60 mg/kg×2 ＋ sTBI 10 Gy for 12 patients,sTBI 7 Gy ＋ Cy 60 mg/kg×2 ＋ Ara-C 2 g/（m^2·d）×2 for 5 patients, sTBI 9 Gy ＋ Cy 60 mg/kg×2 ＋VP-16 200 mg/d×2 or VM-26 200 mg/d×2 for4 patients and MAC（Mel 160 mg/m^2 ＋ Ara-C 1 g/m^2 Q 12 h×6次 ＋ Cy 60 mg/kg×2） for 3 patients. All patients received the transplantation of autologous bone marrow activated with IL-2 and interferon-or. The ability of hematopoietic reconstruction, rate of long-term diseases free survival（DFS）, transplantation related mortality, recurrence rate and severe transplantation related complication were study. Results In all patients 22 were successfully reconstructed hemopotesis except 2 died with severe infection in early-stage post-transplantation. In the following up there were 3 patients died of transplant related complications,with 6 patients recurrence and 15 patiens with continueous complete remission 90 （79 - 102） months. The 5-year probabilities of disease-free survival（DFS） and relapse rate for patients were 62.5 %±9.9 % and 27.3 %±9.5 % ,respectively. Conclusion Transplantation of autologous bone marrow activated with recombinant IL-2 and interferon-or is an effective treatment patients with acute leukemia during CR1.

关 键 词：激活骨髓 自体骨髓移植 急性白血病 

分 类 号：R733.71[医药卫生—肿瘤]