异基因外周血造血干细胞移植治疗白血病  

Allogeneic Peripheral Blood Stem Cell Transplantation in the Treatment of Leukemia

作　　者：李烽[1] 杨瑞芬[1] 王爱民[1] 蔡林[1] 王锦泰[1] 陈捷[1] 吴颖[1] 陈向齐[1] 

机构地区：[1]南京军区福州总医院,350025

出　　处：《中国医师杂志》1999年第9期14-16,19,共4页Journal of Chinese Physician

摘　　要：探讨用 Ｈ Ｌ Ａ 相合的同胞异基因外周血干细胞移植治疗急性髓细胞白血病及 Ａ Ｂ Ｏ 血型不合的 Ｐ Ｂ Ｓ Ｃ Ｔ 的情况，采用 Ｃ Ｔ Ｘ６０ｍｇ／ｋｇ ×２ ＋ Ｔ Ｂ Ｉ７０ ～７５ Ｇｙ 直线加速器照射＋ Ｃ Ｃ Ｎ Ｕ５０ｍｇ／ｋｇ ×１ ± Ｖ Ｐ１６３０ｍｇ／ｋｇ ×１ 对受者作预处理，供者经 Ｇ－ Ｃ Ｓ Ｆ６μｇ／ｋｇ ×５ｄ 动员后，用血细胞分离机（ Ｂａｘｔｅｒ Ｃ Ｓ３０００ｐｌｕｓ） 分离采集干细胞去除红细胞。对 Ａ Ｂ Ｏ 血型不合的 Ｐ Ｂ Ｓ Ｃ，强化移植物抗宿主病（ Ｇ Ｖ Ｈ Ｄ） 预防方案中 Ｍ Ｔ Ｘ 用量及次数；选输合适血制品。结果３ 例病人输注单个核细胞数分别为４０ 、１００ 、５０ ×１０８／ｋｇ ， Ｃ Ｄ３４ ＋ 细胞分别为３６ 、１９０ 、２０ ×１０６／ｋｇ ；干细胞悬液中红细胞残存量分别为２３ｍｌ、１４ｍｌ、２６ ｍｌ，红细胞残存率分别为４ ％ 、３ ％ 、５３ ％ 。移植后造血重建迅速。例１ 于＋ ３４ｄ 染色体完全转变为供者型；例２ 于＋ ４０ｄ 血型完全转变为供者型，＋ ４５ｄ 染色体完全转变为供者型，例３ ＋ ５５ｄ 血型完全转变为供者型。没有输血溶血和免疫溶血发生。例２ 为主，次要 Ａ Ｂ Ｏ 均不合，则早期?To study allogeneic peripheral blood stem cells transplantation(ALLO-PBSCT) for acute myelogenous leukemia and ABO-incompatible PBSCT.Three recipients were pretreated with TBI/CTX/CCNU/±VP 16 .The donors were mobilized by G-CSF,PBSC without erythrocytes were isolated and collected by leukophereses with Baxter CS 3000 plus.In ABO-incompatible PBSCT,MTX in graft-versus host disease(GVHD) prophylactic scheme was intensified;The blood products of transfusion were compatible with the blood group and hemagglutinin of the recipient at this time.The results were follows:the MNC infused in case 1,2 and 3,were 4 0,10 0,5 0×10 8/kg respectively.The CD 34 + cells infused were 3 6,190,2 0×10 6/kg respectively,the red cells residual volumes were 2.3ml,1.4ml and 2.6ml respectively,and the red cell residual rates were 4%,3%,5 3% respectively.The hematopoitic reconstruction was rapid.In case 1,2 and 3 the chromosome turn into the donor type completely at +34 day,+45 day,+55 day respectively.The case 2 (ABO both major and minor incompatible) received the group “AB” platelets and “O” red cells.Three patients have only mild aGVHD(Ⅰ 0) of skin.The haemopoiesis recovery of PBSCT was much faster than that of BMT group.Acute GVHD wasn't more or more serious than that of BMT group.The patients with ALLO-PBSCT have less risk of infection and hemorrhage and reduced the need of blood product support.The suggest that ABO-incompatible PBSCT was safe without interfere with engraftment.

关 键 词：异基因 外周血 造血干细胞移植 白血病 血型不合 

分 类 号：R733.710.5[医药卫生—肿瘤]