化疗联合亲缘HLA不全相合造血干细胞输注治疗血液系统恶性疾病  

Chemotherapy combined with infusion related HLA-mismatched hematopoietic stem cells for hematologic malignancies： a novel therapeutic strategy

作　　者：付丽[1] 王婷婷[1] 魏娜[1] 黄达永[1] 刘锦丽[1] 王昭[1] 

机构地区：[1]首都医科大学附属北京友谊医院血液科,100050

出　　处：《白血病．淋巴瘤》2013年第6期379-382,共4页Journal of Leukemia & Lymphoma

摘　　要：目的明确化疗联合亲缘HLA不全相合造血干细胞输注治疗血液系统恶性疾病的疗效及安全性。方法9例血液系统恶性疾病患者化疗后36h回输亲缘HLA不全相合造血干细胞，评价其疗效、造血恢复时间及并发症。结果9例患者包括4例急性髓系白血病、1例急性B淋巴细胞白血病、2例多发性骨髓瘤、1例霍奇金淋巴瘤、1例弥漫大B细胞淋巴瘤；年龄29～67岁；共接受治疗19例（次），每个疗程平均回输单个核细胞计数（3．12±1．29）×10^8／kg，CD击细胞计数（1．71±1．00）×10^6／kg；CD；细胞计数（2．13±0．99）×10^8／kg。完全缓解4例，部分缓解1例，疾病进展4例。随访2～14个月，生存4例，死亡5例。9例患者输注亲缘HLA不全相合造血干细胞过程顺利，无病例检测到供者嵌合状态，未出现移植物抗宿主病。结论化疗联合亲缘HLA不全相合造血干细胞输注治疗血液系统恶性疾病操作简单且经济，供者来源丰富且易获得，具有良好的安全性和耐受性。Objective To investigate the therapeutic outcomes of chemotherapy with infusion related HLA-mismatched hematopoietic stem cells for hematologic malignancies. Methods Therapy responses and hematopoietic recovery as well as complications of 9 patients were analyzed. Results In the 9 patients aged 29-67 years, four were acute myeloid leukemia, one was acute B lymphocytic leukemia, two were multiple myeloma, one was Hodgkin＂ s disease, one was diffuse large B cell lymphoma. The average of MNC was （3.12 ±1.29） ×10^8/kg, CD34＋ cells was （1.71±1.00）×10^6/kg, and CD3＋ cells was （2.13 ±0.99） ×10^8/kg. There was complete remission in four patients, partial remission in one, disease progression in four. Following up 2 to 14 months, four patients were in survival. No donor chimerism was detected and no graft-versus-host disease was observed in any patient. Conclusion Chemotherapy with infusion related HLA-mismatched hematopoietic stem ceils for hematologic malignancies may provide a promising treatment method as a novel therapeutic strategy.

关 键 词：造血干细胞移植 血液肿瘤 嵌合状态 移植物抗宿主病 抗肿瘤联合化疗方案 

分 类 号：R733[医药卫生—肿瘤]