异基因外周造血干细胞移植治疗造血系统恶性肿瘤的临床研究  

Treatment of hematopoietic malignancies with allogeneic peripheral blood stem cell transplantation

作　　者：张永宁[1] 季勇慧[1] 吴朝阳[1] 林江[1] 江云伟[1] 王法春[1] 钱军[1] 

机构地区：[1]江苏大学附属人民医院血液科,江苏镇江212002

出　　处：《江苏大学学报（医学版）》2006年第6期489-492,共4页Journal of Jiangsu University：Medicine Edition

摘　　要：目的：探讨异基因外周造血干细胞移植（Allo—PBSCT）治疗恶性血液病的疗效、造血重建及并发症情况。方法：对5例恶性血液病患者进行Allo．PBSCT治疗，包括急性中幼粒细胞性白血病（AML）3例、急性淋巴细胞性自血病（ALL）1例、非霍奇金氏淋巴瘤（NHL）1例，均为供受者HLA配型完全相合，其中同胞间移植4例、无关供者移植1例；4例采用清髓性预处理方案，1例为非清髓性预处理方案。结果：5例患者均获得造血重建，经血型、性染色体和短串联重复序列-聚合酶链反应检测证实均为供者型造血，中性粒细胞≥0．5×10^9／L的中位时间为移植后＋12天，血小板≥20×10^9／L的中位时间为移植后＋8天；5例患者均未发生肝静脉闭塞病；4例患者发生急性移植物抗宿主病（aGVHD）；1例患者发生移植后单纯红细胞性再生障碍性贫血（PRCA），其余4例患者仍持续缓解（移植后145—470天）。结论：Allo-PBSCT是治疗恶性血液病的有效手段，尤其是对于复发难治性患者具有较好疗效。Objective： To explore the clinical effect, hematopoietic reconstruction, and complications of allogeneic peripheral blood stem cell transplantation （AUo-PBSCT） on hematopoietic malignancies. Methods： Five patients were treated with Allo-PBSCT, including 3 acute myeloid leukemia （AML）, 1 acute lymphoblastic leukemia （ALL）, and 1 non-Hodgkin lymphoma （NHL）. All patients were completely HLA matched, in four of which HSCs were obtained from sibling donors and one from unrelated donor. Four patients received myeloablative conditioning and one received non-myeloablative conditioning. Results： All five patients＇achieved hematopoietic reconstruction and were converted to full donor chimerism according to blood typing, sex chromosome analysis, and short tandem repeat sequence-polymerase chain reaction detection. The median time for neutrophil and platelet recoveries was post-transplantation ＋ 12 days and ＋ 8 days respectively. Acute graft versus host disease （aGVHD） occurred in four patients. Hepatic vein occlusive disease happened in no patients. Four cases remained in continuous complete remission after a followup of 145 -470 days and one was complicated with pest-transplanted pure red cell anaplastic anemia. Conclusion： Allo-PBSCT was an effective means for treatment of malignant hematopoietic diseases, especially for those relapse or refractory types.

关 键 词：血液病 恶性 造血干细胞移植 外周血 异基因 移植物抗宿主病 

分 类 号：R392.4[医药卫生—免疫学]