异基因外周血干细胞移植治疗白血病5例报告  

Application of Allogeneic Peripheral Blood Stem Cells Transplantation in 5 Patients with Leukemia

作　　者：邬国和[1] 赵恒[1] 张华[1] 李东宁[1] 颜丽华[1] 李萍[1] 

机构地区：[1]南昌市第一医院,江西南昌330008

出　　处：《江西医学院学报》2006年第1期44-46,49,共4页Acta Academiae Medicinae Jiangxi

摘　　要：目的观察异基因外周血干细胞移植(PBSCT)治疗白血病(Leukemia)的疗效与副作用。方法所选供者均为HLA-A、B、DR位点与患者完全相合的同胞兄弟姐妹。供者经250μg/kg rhG-CSF动员5 d后,单采外周血干细胞1~2次。5例白血病病人经过改良BU/CY预处理方案,输入单个核细胞6.77×108/Kg±1.63×108/kg(5×108/kg^8.67×108/kg),其中CD34+为13.88×106/kg±8.15×106/kg(5.3×106/kg^24.23×106/kg),用MTX+CSA+MMF预防急性移植物抗宿主病(aGVHD)。结果移植-2 d^+2 d WBC降至最低,+11 d^+20 d中性粒细胞>0.5×109/L,+11 d^+55 d血小板>50×109/L。+28 d复查骨髓显示造血恢复、STR位点的DNA检查显示供者细胞生长。随访1年~2年,其中2例出现aGVHD、3例出现cGVHD、2例出现感染、1例出现CNSL,最后骨髓复发死亡。结论采用改良Bu/Cy方案和用MTX+CSA+MMF预防急性移植物抗宿主病(aGVHD)方案进行PBSCT治疗白血病是一种安全、可靠的治疗方法。Objective To observe the efficacies and side effects of allogeneic peripheral blood stem cells transplantation （PBSCT） in patients with leukemia. Methods The donors were the sibling and were matched with the recipient in HLA-A, B, DR locus. After mobilization with 250ug/day Filgrastim （rhG-CSF）for 5 days,peripheral blood stem cells were collected for 1 to 2 times. Five patients with leukemia received 6.77 × 10^8/kg±1. 63 × 10^8/kg（5 × 10^8/Kg-8. 67 × 10^8/kg） peripheral blood mononuclear cells（MNC）which contained 13.88 × 10^6/kg±8. 15 × 10^6/ Kg（5.3 × 10^6/Kg- 24.23 × 10^6/Kg） CD34 ＋ cells after modified Bu/Cy conditioning regiment and MTX＋CSA＋ MMF were given for prophylaxis of acute graft versus-host disease （aGVHD）. Resuits The WBC was reduced to the lowest at 2 days×＋2day after transplantation. Time when there were more than 0.5 × 10^9/L neutrophils was ＋ 11day- ＋ 20day and ＋ 1day- ＋ 55 days were need for getting more than 50× 10^9/L platelets was. Bone marrow presented hematopoiesis recovery at W28 day, examination of STR in DNA showed donor cells were prolifelation in the patient. After 1 to 2 yeays observation,there were 2 cases of aGVHD,3 cases of cGVHD,2 cases of infection and 1 case of CNSL which at last relapsed in bone marrow took place. Conclusion PBSCT in the treatment of leukemia with modified Bu/Cy conditioning regimen and MTX＋CSA ＋MMF prophylaxis of aGVHD is safe and reliable.

关 键 词：异基因外周血造血干细胞移植 白血病 改良Bu/Cy预处理方案 移植物抗宿主病 

分 类 号：R557[医药卫生—血液循环系统疾病]