非骨髓清除性异基因外周血造血干细胞移植(NST)治疗恶性血液病的初步临床研究  

The Clinical Study of the Nonmyeloablative Stem Cell Transplantation (NST) to Treat Malignant Hematologic Diseae

作　　者：马骁[1] 吴德沛[1] 孙爱宁[1] 唐晓文[1] 傅琤琤[1] 常伟荣[1] 朱子玲[1] 夏学鸣[1] 林宝爵[1] 

机构地区：[1]苏州大学附属第一医院血液科,苏州215006

出　　处：《苏州大学学报（医学版）》2002年第3期278-281,共4页Suzhou University Journal of Medical Science

摘　　要：目的　探讨NST治疗恶性血液病的效果及毒性。方法　急性粒细胞白血病未分化型 (AML -M1)、慢性髓细胞白血病 (CML)、骨髓增生异常综合征 (MDS -RA)患者各 1例 ,供体为其HLA配型完全相合的同胞。供体动员方案 :G -CSF 30 0 μg/ 12h× 5d后分离采集外周血干细胞。所获CD34 + 细胞数分别为 6 .36× 10 6/kg、9.72×10 6/kg、6 .6 2× 10 6/kg ;单个核细胞数 (MNC)分别为 14.0× 10 8/kg、10 .47× 10 8/kg、8.5 8× 10 8/kg ;T细胞总数分别为 8.80× 10 8/kg、7.12× 10 8/kg、5 .6 7× 10 8/kg ;CFU -GM数分别为 16 2个 / 2× 10 5MNC、184个 / 2× 10 5MNC、182个 / 2× 10 5MNC。预处理方案 :Fludarabine:30mg/m2 ·d-1× 6d ,Bu :4mg/kg·d-1× 2d ,ALG :12mg/kg·d-1× 4d ,Ara-C :10 0mg/m2 ·d-1× 3d。单用环胞菌素 (CSA)预防移植物抗宿主病 (GVHD)。移植后未用造血生长因子。结果　患者均能顺利完成预处理方案 ,没有严重并发症出现。移植后 10～ 13d造血重建。未发生急性GVHD。随访10 0～ 16 0d ,血常规、骨髓象均正常 ,1例发生肝脏型慢性GVHD。结论　NST能有效治疗恶性血液病 ,方案相关毒性小 ,适用范围广 ,移植相关并发症少 ,造血重建迅速。Objective To explore the efficiency and toxicity of nonmyeloablative stem cell transplantation(NST) for malignant hematological disease.Methods Three patients received NST from HLA-compatible sibling donors. Peripheral blood stem cells were mobilized by G-CSF 300μg/12h×5d.To these three patients, 6.36×10 6 CD34 + cells/kg, 9.72×10 6 CD34 + cells/kg and 6.62×10 6 CD34 + cells/kg were transplanted. The conditioning regimen included: (Fludarabine 30mg/m 2·d -1 ) ×6d, (Busulfan 4mg/kg·d -1 )×2d, (ALG 12mg/kg·d -1 ) ×4d and (Ara-C 100mg/ m 2·d -1 ) ×3d.CSA was used to protect GVHD only and no G-CSF was taken after NST. Results Every patient received the conditioning regimen without serious complications.Without giving G-CSF, hematopoietic reconstitution obtained on the 10th to 13th day after NST. No acute graft versus host disease(GVHD) occurred. In the follow-up duration of 100 to 160 days, the blood and bone marrow picture was normal and the living status was good.In case 1 chronic heaptic GVHD occurred. Conclusion NST is an effective therapy in the treatment of malignant hematologic disease.

关 键 词：非骨髓清除性异基因外周血赞赏血干细胞移植 造血干细胞移植 恶性血液病 疗效 毒性 

分 类 号：R733.05[医药卫生—肿瘤]