供者淋巴细胞输注联合化疗治疗异基因造血干细胞移植后白血病复发的护理  

Nursing of donor lymphocyte infusions combined with chemotherapy in the treatment of relapsed leukemia after allogeneic hematopoietic stem cell transplantation

作　　者：王翠林[1] 陈惠勤[1] 吴燕君[1] 

机构地区：[1]广州市第十二人民医院血液内科,510620

出　　处：《国际护理学杂志》2012年第5期925-927,共3页international journal of nursing

摘　　要：探讨供者淋巴细胞输注（DLI）联合化疗治疗异基因造血干细胞移植（Allo—HSCT）后白血病复发的疗效、并发症及护理方法。对Allo—HSCT后白血病复发的6例患者予分次逐渐提高单次剂量方案（EDR）的DLI联合化疗治疗，观察输注后白血病血液学完全缓解（cR）率、无病生存（DFS）率、移植物抗宿主病（GVHD）和骨髓抑制发生率、输注时尿常规，患者的反应情况。输注过程仅有2例轻微发热，6例均获得血液学cR，cR率100％，STR—PCR测定证实恢复为供者基因型；随访70d至14个月，2例DLI后50d发生慢性GVHD，发生率33．2％，无1例发生急性GVHD，2例全血细胞减少骨髓抑制，发生率33．2％；5例DFS，1例于DLI后70d死于CMV性间质性肺炎。随访至今，5例DFS患者血象和骨髓象一直正常。EDR。To observe effects and complications of donor lymphocyte infusions （DLI） combined with chemotherapy in the treatment of relapsed leukemia after allogeneic hematopoietic stem cell transplantation for improving nursing technology. Six patients received DLI com- bination chemotherapy in the treatment of relapsed leukemia after allogeneic hematopoietic stem cell transplantation. After treatment, the hematological complete remission （ CR ） rate , disease free surviva （DFS） rate, graft - versus - host disease （ GVHD ） and bone marrow suppression incidence were observed. Two cases had low fever during infusion. After treatment, all cases got blood CR, and the CR rate was 100%. Determination of STR - PCR confirmed the recovery of donor genotype. In the 70days to 14 months follow - up, 2 cases got chronic GVHD after 50 days , and the incidence rate was 33.2%. No case got acute GVHD. 2 patients suffered with pancytopenia that caused by bone marrow suppression, and the occurrence rate was 33.2%. 5 patients got disease free survival （ DFS ） . 1 cases died of CMV intersti- tial pneumonia after 70 days . 5 patients had normal hemogram and myelogram from then on. DLI combined with chemotherapy in the treat- ment of relapsed leukemia after allogeneic hematopoietic stem cell transplantation is safe and effective.

关 键 词：供者淋巴细胞输注 化疗 异基因造血干细胞移植 白血病 复发 护理 

分 类 号：R457.7[医药卫生—治疗学]