混合造血干细胞移植联合DLI-IL-2治疗急性髓性白血病的疗效  

Efficacy of mixed hematopoietic stem cell transplantation combined with donor lymphocyte infusion and IL-2 in treatment of acute myelogenous leukemia

作　　者：王存邦[1] 白海[1] 葸瑞[1] 潘耀柱[1] 张茜[1] 周进茂[1] 吴涛[1] 徐淑芬[1] 

机构地区：[1]兰州军区总医院全军血液病中心,甘肃兰州730050

出　　处：《中国肿瘤生物治疗杂志》2011年第1期55-58,共4页Chinese Journal of Cancer Biotherapy

基　　金：全军"十一五"杰出人才基金资助项目( No. 06J005);兰州军区医药科研基金项目( No. LXH -2007006)~~

摘　　要：目的:探讨急性髓性白血病(acute myelogenous leukemia,AML)患者采用自体外周血干细胞混合HLA半相合异体骨髓移植(autologous peripheral blood stem cell mixed with HLA haploidentical allogeneic bone marrow transplantation,Mixed-HSCT)联合供体淋巴细胞输注+白介素2(donor lymphocyte infusion combined interleukin-2,DLI-IL-2)治疗的疗效。方法:采用联合治疗方案的试验组23例AML患者中男性15例、女性8例,中位年龄22(17～41)岁;采用单纯移植治疗的对照组14例AML患者中男性10例、女性4例,中位年龄21(19～40)岁。两组患者在完全缓解期采用TBI+VEMAC方案预处理,对照组患者接受单纯Mixed-HSCT移植,试验组患者接受Mixed-HSCT且造血重建后继续DLI-IL-2治疗1～8次;各组在治疗前后进行染色体核型分析及骨髓检查。随访时间>3年。结果:两组患者均获得造血重建,无移植物抗宿主病(graft-versus-host disease,GVHD)发生。试验组有6例形成混合嵌合体(46XX/46XY),随访显示存活15例,长期无病存活率(disease-free survival,DFS)为65.2%;对照组有3例形成混合嵌合体(46XX/46XY),随访显示存活7例,DFS为50.0%。两组患者治疗后的不良反应(口腔溃疡、出血性膀胱炎、发热等)相似。结论:Mixed-HSCT联合DLI-IL-2治疗对AML患者长期无病生存有积极意义,无严重不良反应。Objective：To study the efficacy of mixed-HSCT （autologous peripheral blood stem cell mixed with HLA haploidentical allogeneic bone marrow transplantation） combined with donor lymphocyte infusion plus interleukin-2 （DLI＋IL-2） in treatment of acute myelogenous leukemia （AML） patients. Methods：Twenty-three AML patients （15 males and 8 females,median age 22 years） were enrolled in this study as mixed-HSCT combined DLI＋IL-2 group,and 14 AML patients （10 males and 4 females,median age 21 years） were enrolled as control group. All patients in the two groups received TBI＋VEMAC therapy after complete remission,patients in the control group were treated with mixed-HSCT alone,and those in the experimental group were treated with Mixed-HSCT and further treatment with DLI＋IL-2 for 1-8 times after hematopoietic reconstruction. All the patients were followed up for at least 3 years. Results：All patients in the two groups achieved hematopoietic reconstruction and had no graft-versus-host disease （GVHD）. During 3 years,6 cases in the experimental group formed mixed chimerism （46XX/46XY） and 15 survived,with the disease-free survival rate （DFS） being 65.2%. Three cases in the control group formed mixed chimerism （46XX/46XY） and 7 cases survived,with the DFS being 50.0%. All patients in the two groups had similar adverse reactions （oral cavity ulcer,hemorrhagic cystitis,fever,etc.） after therapy. Conclusion：Mixed-HSCT combined with DLI＋IL-2 has a positive effect on DFS of AML patients,with no noticeable adverse reactions.

关 键 词：急性髓性白血病 混合造血干细胞移植 供者淋巴细胞输注 白介素-2 

分 类 号：R733.7[医药卫生—肿瘤] R730.54[医药卫生—临床医学]