异基因造血干细胞移植联合伊马替尼治疗成人Ph+急性淋巴细胞白血病临床观察  

Clinical efficiency of allogenic hematopoietic stem cell transplantation combined with imatinib in treatment of Philadelphia positive acute lymphoblastic leukemia

作　　者：刘嘉[1] 高蕾[1] 张曦[1] 陈幸华[1] 高力[1] 李云龙[1] 文钦[1] 

机构地区：[1]第三军医大学新桥医院血液科,全军血液病中心,重庆400037

出　　处：《第三军医大学学报》2012年第24期2453-2455,共3页Journal of Third Military Medical University

摘　　要：目的观察异基因造血干细胞移植(allogenic hematopoietic stem-cell transplantation,allo-HSCT)联合伊马替尼治疗成人Ph+急性淋巴细胞白血病的效果。方法 2008年3月至2010年3月,我科对20例成人Ph+急性淋巴细胞白血病患者采用异基因造血干细胞移植联合伊马替尼方案,其中9例接受同胞间HLA全相合移植,6例接受同胞间HLA单倍型移植,3例接受非血缘关系HLA全相合移植,2例接受非血缘关系HLA半全相合移植。20例患者在明确诊断后开始予化疗联合伊马替尼治疗,移植前2周至移植造血重建前停用伊马替尼,造血功能稳定后继续予伊马替尼维持治疗,移植后应用RT-PCR和FISH方法监测BCR/ABL表达水平。结果 20例患者均成功植入,均未出现严重的移植相关并发症。移植前20例患者接受伊马替尼联合化疗均达到完全缓解(complete remission,CR),BCR/ABL均转为阴性。随访至2012年3月,20例患者中15例骨髓持续CR,BCR/ABL持续阴性,5例复发。结论异基因造血干细胞移植联合伊马替尼是治疗Ph+急性淋巴细胞白血病的有效方法。Objective To determine the effect of allogenic hematopoietic stem cell transplantation （AIlo-HSCT） combined with imatinib on Philadelphia positive acute lymphoblastic leukemia （ALL）. Methods Twenty Philadelphia positive ALL patients received Allo-HSCT combined with imatinib in our department from March 2008 to March 2010. There were HLA-identical sibling HSCT in 9 cases, HLA-haplotype sibling HSCT in 6 cases, HLA-identical unrelated HSCT in 3 cases, and HLA-mismatched unrelated HSCT in 2 cases. All patients were given the treatment of chemotherapy combined with imatinib after diagnosis. In 2 weeks before transplantation to hematopoietic reeonstitution, imatinib was stopped to administer. After hematopoietic function was stabilized, treatment of imatinib was continued. The level of BCR/ABL mRNA was monitored using real- time PCR and fluorescence in situ hybridization （FISH）. The last follow-up was carried out in March 2012. Results Chemotherapy combined with imatinib treatment resulted in complete response in all 20 patients before HSCT. The level of BCR/ABL mRNA was declined and reached to zero level. All 20 patients achieved stable engraftments without severe transplantation related complications. Until March 2012, 15 of the 20 patients＇ bone marrow continued CR, and BCR/ABL fusion gene continued negative, and 5 of the 20 patients relapsed. Conclusion Allo-HSCT combined with imatinib is an effective regimen for Philadelphia positive ALL.

关 键 词：异基因造血干细胞移植 伊马替尼 Ph+急性淋巴细胞白血病 

分 类 号：R617[医药卫生—外科学] R733.71[医药卫生—临床医学]