造血干细胞移植治疗血液肿瘤的临床研究  

Study on the treatment of hematological manignancy with hematopoietic stem cell transplantation

作　　者：刘欣[1] 孙自敏[1] 王祖贻[1] 刘会兰[1] 朱薇波[1] 吴竞生 汝文华[1] 

机构地区：[1]安徽省立医院血液科,合肥230001

出　　处：《安徽医科大学学报》2004年第1期62-65,共4页Acta Universitatis Medicinalis Anhui

摘　　要：目的　探讨造血干细胞移植 (HSCT)治疗血液肿瘤的造血重建、疗效和移植相关并发症。方法　① 8例血液肿瘤患者中 ,采用自体外周血干细胞移植 (APBSCT) 2例 ,自体骨髓移植 (ABMT) 1例 ,HLA 1～ 2个位点不合无关脐血移植(UCBT) 3例 ,异基因外周血干细胞移植 (Allo PBSCT) 2例 ,分别采用CBV、Bu/Cy、Bu/Cy/BCNU和Cy/TBI 4种方案进行预处理。②患者自体外周血干细胞 (PBSC)动员方案采用Cy/G CSF ,异基因供者PBSC动员方案采用G CSF/GM CSF。③在异基因HSCT中采用环孢霉素A(CsA)和霉酚酸酯 (MMF)预防急性GVHD(aGVHD)。④应用小剂量肝素预防肝静脉闭塞病 (VOD)。结果　① 3例接受自体HSCT的患者移植后均获得完全缓解 (CR) ,2例移植后淋巴瘤复发。 5例接受异基因HSCT治疗的患者中有 1例未植入 ,异基因HSCT的植入率为 80 %。 8例移植成功率为 87 5 %。② 8例患者移植后于 3～ 7d(中位时间为 4 5d)开始骨髓脱空 ,骨髓脱空时间持续 3～ 9d(中位时间为 5d) ,外周血中性粒细胞绝对值 (ANC) >0 5× 10 9/L的时间为 9～ 2 7d(中位时间为 14d) ,血小板计数 (BPC) >2 0× 10 9/L的时间为 10～ 4 1d(中位时间为 14d) ,BPC >5 0× 10 9/L的时间为 11～5 3d(中位时间为 14d)。在不同类型的HSCT中以APBSCT和Allo PBSCT造血?Objective To investigate the hematopoietic reconstitution,treatment outcome and transplant-related complications of hematopoietic stem cell transplantation (HSCT). Methods ①Eight patients with hematological manignancy received HSCT containing two case of autologous peripheral blood stem cell transplantation (APBSCT),one cases of autologous bone marrow transplantation (ABMT),three cases of unrelated HLA-mismatched cord blood transplantation (UCBT) and two cases of allogeneic peripheral blood stem cell transplantation (Allo-PBSCT). The conditioning regimens consisted of CBV,Bu/Cy,Bu/Cy/BCNU and Cy/TBI. ②The peripheral blood stem cell (PBSC) mobilization regimens were Cy/G-CSF in APBSCT and G-CSF/GM-CSF in Allo-PBSCT. ③Cyclosporine(CsA) combined with mycophenolate mofetil (MMF) were used for the prevention of acute graft-versus-host disease (GVHD) in allogeneic HSCT. ④The prognosis of hepatic veno-occlusive disease (VOD) was used by low dose heparin. Results ①Three patients receiving autologous HSCT achieved complete remission (CR) after transplantation and two relapsed. Of the five recipients in allogeneic HSCT,one recipient had no engraftment. The engraftment rate of allogeneic HSCT was 80 percent. The rate of succeeding in transplantation in eight patients was 87 5 percent. ②In the eight recipients, myeloablation occurred from day 3 to day 7 (median day 4 5) after-transplantation and lasted for 3 days to 9 days (median 5 days). The peripheral blood absolute neutrophil count (ANC)of >0 5×10 9/L occurred at day 9 to day 27 (median day 14), blood platelet count(BPC) of >20×10 9/L occurred at day 10 to day 41 (median day 14) and BPC of >50×10 9/L occurred at day 11 to day 53 (median day 14). In all kinds of HSCT, the hematopoietic reconstitution in APBSCT and Allo-PBSCT occurred earlicr and those of ABMT and UCBT were relatively later. ③In five recipients of allogeneic HSCT, three recipients had acute GVHD (grade Ⅰ to Ⅱ), the occurrence rate of acute GVHD was 60 percent. In the eigh

关 键 词：造血干细胞移植 治疗 血液肿瘤 并发症 白血病 淋巴瘤 

分 类 号：R733[医药卫生—肿瘤] R730.5[医药卫生—临床医学]