非清髓异基因外周造血干细胞移植治疗白血病疗效观察  

Effect of Nonmyeloablative Allogeneic Peripheral Blood Hematopoietic Stem Cells Transplantation for Leukemia

作　　者：李玉富[1] 张艳莉[1] 房伯俊[1] 高全力[1] 白献红[1] 冯蕙霞[1] 朱兴虎[1] 魏旭东[1] 宋永平[1] 

机构地区：[1]河南省肿瘤医院血液科,郑州市450008

出　　处：《医药论坛杂志》2007年第17期51-53,共3页Journal of Medical Forum

摘　　要：目的探讨非清髓性异基因外周血造血干细胞移植(NAPBSCT)治疗年龄较大的白血病患者安全性和疗效。方法采用NAPBSCT治疗6例45～65岁白血病患者,其中急性淋巴细胞白血病1例,淋巴瘤细胞白血病2例,急性粒细胞白血病1例,慢性粒白血病2例。以FAC为预处理方案,氟拉达宾(Flud)50mg/d(-6d～-2d)(以造血干细胞输注当日为0d,输注前为"-",输注后为"+"),抗淋巴细胞免疫球蛋白(ALG)15mg/(kg.d)(-6～-2d),环磷酰胺(CTX)30mg/(kg.d)(-4～-3d)。于+30d进行第1次供者淋巴细胞输注,每4周1次,共6次。输注的供体淋巴细胞数由5×104/kg逐渐增加至1.5×108/kg。结果1例患者于移植后56天死于急性移植物抗宿主病(aGVHD),1例患者于移植后81天死于肺部真菌感染,其余4例患者目前均存活,最长的1例已存活达35个月。6例患者在移植早期均形成混合性嵌合体和血液学部分缓解,供体淋巴细胞输注后有3例患者形成供体型完全嵌合体,并达到血液学完全缓解。结论非清髓性外周血造血干细胞移植治疗年龄较大的白血病患者较为安全且疗效较好。Objective To probe into therapeutic effect and safety of nonmyeloablative allogeneic peripheral blood hematopoietic stem cells transplantation（NAPBSCT） in treating old leukemia patients. Methods Adopt NAPBSCT to treat leukemia patients,45 -65 years old, 6 cases in all,acute lymphocyte leukemia 1 case, lymphomatous leukemia 2 cases, acute myelogenous leukemia 1 case, chro- nic myelogenous leukemia 2 cases. The patients received reduced dose FAC pretreatment regimen, fludarabine 50mg/d（ - 6d - - 2d）, anti - lymphocyte immunoglobulin 15mg/（ kg·d ） （ - 6d - - 2d）, and cyclophosphamide 30mg/（ kg·d） （ - 4～ - 3d）. The first time donor lymphocyte infusion （ DLI ） arrange on ＋ 30d ,one time per four weeks ,six times in all. Infusion T lymphocytes arrange 5 × 10^4/kg to 1.5× 10^8/kg per time. Results 1 patient died from aGVHD at ＋ 56d, 1 patient died from lung fungi infection at ＋ 81 d, other 4 patients survive up to now, and 6 cases established mixed chimerism and partial response of hematology in the early stage of NAPBSCT, 3 patients all established complete chimerism and complete response of hematology after DLI. Conclusion NAPBSCT is safe and effective means in treating old leukemia patients.

关 键 词：造血干细胞移植 非清髓 供体淋巴细胞输注 白血病 

分 类 号：R733.7[医药卫生—肿瘤]