双次自体外周血干细胞移植治疗多发性骨髓瘤  

Double Times of Autologous Peripheral Blood Stem Cell Transplantation to Treat Multiple Myeloma

作　　者：张小荣[1] 苏丽萍[1] 许莲蓉[1] 朱秋娟[1] 

机构地区：[1]山西医科大学第二医院血液科,太原030001

出　　处：《中国实验血液学杂志》2007年第4期866-869,共4页Journal of Experimental Hematology

摘　　要：为了探讨双次自体外周血干细胞移植治疗多发性骨髓瘤(MM)的安全性及疗效,为1例49岁女性MM患者行双次自体外周血干细胞移植。第1次移植的动员方案:环磷酰胺2g/m2×1天,粒细胞集落刺激因子(G-CSF)[(10μg/(kg.d)]×5天。预处理方案:马法兰(melphalan)200mg/m2。自体外周血干细胞回输:单个核细胞(MNC)6.1×108/kg;CD34+细胞4.7×106/kg。6个月后行第2次移植的动员方案:G-CSF[(10μg/(kg.d)]×5天。预处理方案:马法兰200mg/m2。自体外周血干细胞回输:MNC10.2×108/kg;CD34+细胞5.9×106/kg。结果表明:第1次移植后17天中性粒细胞绝对值(ANC)回升至0.5×109/L,15天血小板回升至20×109/L;第2次移植后22天ANC回升至0.5×109/L,13天血小板回升至20×109/L。双次移植过程中均未出现明显毒副反应,无严重并发症。经上述治疗后患者的骨痛、贫血症状消失,第2次移植后随访7个月,患者情况良好,仍处于完全缓解(CR)状态。结论:双次自体外周血干细胞移植治疗多发性骨髓瘤是安全、有效和可行的。In order to explore the security and feasibility of double autologous peripheral blood stem cell transplantation （APBSCT） for treatment of multiple myeloma, a 49 years old female patient with multiple myeloma was therapied with double APBSCT. The first peripheral blood stem cell （PBSC） mobilization regimen included CTX 2 g/m^2 ×1d and G-CSF [10 μg/（kg · d）] ×5 d. The conditioning regimen was given melphalan 200 mg/m：. The transplanted number of mononuclear cells was 6.1 × 10^8/kg and that of CD34^＋ cells was 4.7 × 10^6/kg. The second APBSCT was performed six months later. PBSC mobilization regimen was G-CSF [ 10 μg/（ kg · d） ] × 5 d. The conditioning regimen was melphalan 200 mg/m^2. The transplanted number of mononuclear cells was 10.2 × 10^8/kg and that of CD34^＋ cells was 5.9 × 10^6/kg. The results showed that the absolute neutrophil count （ANC） rose to above 0.5 × 10^9/L on day 17 and platelet count exceeded 20 × 10^9/L on day 15 after first transplantation. After second transplantation ANC rose to above 0.5 × 10^9/L on day 22 and platelet count exceeded 20 × 10^9/L on day 13. There were neither obvious adverse reaction nor severe complication during the double transplantations. The patient＇s ostealgia and anemia were healed through above therapy. In the follow-up of 7 months, the patient＇s general status was good and she remained in complete remission phase. It is concluded that double APBSCT is safe, effective and feasible for the treatment of multiple myeloma.

关 键 词：多发性骨髓瘤 外周血干细胞移植 双次自体移植 

分 类 号：R733.3[医药卫生—肿瘤]