非T细胞去除单倍体造血干细胞移植治疗T淋巴母细胞性淋巴瘤的初步临床研究  

Non-T cell depletion haploidentical hematopoietic stem-cell transplantation for T lymphoblastic lymphoma

作　　者：何雪峰[1] 吴德沛[1] 孙爱宁[1] 张翔[1] 仇惠英[1] 韩悦[1] 唐晓文[1] 傅琤琤[1] 金正明[1] 

机构地区：[1]苏州大学附属第一医院江苏省血液研究所卫生部血栓与止血重点实验室,215006

出　　处：《白血病．淋巴瘤》2011年第8期459-463,共5页Journal of Leukemia & Lymphoma

基　　金：江苏省高校优势学科建设工程项目

摘　　要：目的探讨非T细胞去除单倍体造血干细胞移植（haplo—HSCT）治疗T淋巴母细胞性淋巴瘤（T-LL）的疗效。方法3例确诊的T—LL患者获得缓解后接受了粒细胞集落刺激因子（G．CSF）动员后的非T细胞去除的单倍体亲缘供体的骨髓干细胞输注。其中2例患者预处理采用包含环磷酰胺（CTX）、全身照射（TBI）和阿糖胞苷（Ara-C）的清髓性方案，另1例患者采用包含CTX和白消安（BU）、Ara—C的清髓性方案；3例患者都采用了包含兔抗人胸腺细胞球蛋白（ATG）的加强的急性移植物抗宿主病预防方案。结果所有患者均获得快速完全的造血重建，中性粒细胞和血小板中位恢复时间分别为12d和13d。3例患者中位随访24个月（9-75个月），均无瘤生存。结论非T细胞去除haplo-HSCT治疗T-LL的相关不良反应可以耐受，患者可能获得长期生存。Objective To explore the efficacy of non-T cell depletion haploidentical hematopoietic stem-cell transplantation for T lymphoblastic lymphoma （T-LL）. Methods 3 T-LL patients achieving complete remission received haploidentical bone marrow stem cell transplantation with granulocyte-colony-stimulating factor （G-CSF） mobilized hone marrow grafts from related donor without T-cell depletion. Two of them received a myeloablative conditioning regimen consisting of high-doses of cyclophosphamide and cytarabine with total body irradiation, whereas the other was preconditioned with busulfan, cyclophosphamide and eytarabine. All patients received strengthened phophylaxis regimen including rabbit anti-thymocyte globulin against acute graft-versus-host disease. Results All patients had rapid hematopoietic engraftment with the median time for neutrophil and platelet recovery being 12 days and 13 days, respectively. They are still alive without relapse at a median follow-up of 24 months （range： 9-75 months）. Conclusion Treatment related toxicity can be acceptable in non-T cell depletion haploidentieal hematopoietic stem-cell transplantation for T-LL and the patients may achieve long term survival.

关 键 词：淋巴瘤 淋巴母细胞 单倍体骨髓移植 清髓性治疗 T-细胞去除 

分 类 号：R733.1[医药卫生—肿瘤]