中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (27): 5123-5126.doi: 10.3969/j.issn.1673-8225.2011.27.042

• 干细胞临床实践 clinical practice of stem cells • 上一篇    下一篇

HLA相合同胞异基因外周血造血干细胞移植治疗急性白血病

陈  波，王志国，张  颢，肖  亮，范艳玲，夏国强，邱  林，展昭民，张伯龙，马  军   

  1. 哈尔滨血液病肿瘤研究所，血液内科，黑龙江省哈尔滨市  150010
  • 收稿日期:2011-01-26 修回日期:2011-03-12 出版日期:2011-07-02 发布日期:2011-07-02
  • 通讯作者: 王志国，硕士，副主任医师，哈尔滨血液病肿瘤研究所血液内科，黑龙江省哈尔滨市150010 wangzhiguo91006@163.com
  • 作者简介:陈波★，男，1979年生，黑龙江省哈尔滨市人，汉族，2002年哈尔滨医科大学毕业，硕士，主治医师，主要从事白血病治疗及造血干细胞移植方面的研究。 chenbo@csco.org.cn

HLA-identical sibling allogeneic peripheral blood stem cell transplantation in the treatment of acute leukemia

Chen Bo, Wang Zhi-guo, Zhang Hao, Xiao Liang, Fan Yan-ling, Xia Guo-qiang, Qiu Lin, Zhan Zhao-min, Zhang Bo-long, Ma Jun   

  1. Department of Hematology, Harbin Institute of Hematology & Oncology, Harbin  150010, Heilongjiang Province, China
  • Received:2011-01-26 Revised:2011-03-12 Online:2011-07-02 Published:2011-07-02
  • Contact: Wang Zhi-guo, Master, Associate chief physician, Department of Hematology, Harbin Institute of Hematology & Oncology, Harbin 150010, Heilongjiang Province, China wangzhiguo91006@163.com
  • About author:Chen Bo★, Master, Attending physician, Department of Hematology, Harbin Institute of Hematology & Oncology, Harbin 150010, Heilongjiang Province, China chenbo@csco.org.cn

PDF

542

被引次数

14

摘要：

背景：HLA相合同胞间异基因外周血造血干细胞移植是治疗急性白血病的一种有效方法。
目的：评价HLA相合异基因外周血造血干细胞移植治疗急性白血病的临床疗效及并发症。
方法：25例急性白血病患者接受HLA相合同胞的异基因外周血造血干细胞移植，其中急性髓系白血病20例，急性淋巴细胞白血病5例。预处理方案为BU+CY方案或CY+TBI方案，移植物抗宿主病预防采用环孢素A+吗替麦考酚酯+短程甲氨蝶呤。
结果：最短随访2个月，最长随访80个月。患者均获造血重建，中性粒细胞≥0.5×109 L-1的时间为10~18 d，血小板≥20× 109 L-1的时间为10~37 d。主要并发症：感染败血症12例，巨细胞病毒感染9例，带状疱疹病毒感染3例，发生急性移植物抗宿主病10例，慢性移植物抗宿主病11例，出血性膀胱炎4例。至随访结束，17例无病生存，8例死亡。提示HLA相合同胞异基因外周血造血干细胞移植是治疗急性白血病安全有效的方法。

关键词: 异基因外周血造血干细胞移植, HLA相合同胞, 急性白血病, 并发症, 细胞移植

Abstract:

BACKGROUND: HLA-identical sibling allogeneic peripheral blood hematopoietic stem cell transplantation (allo-PBSCT) is an effective treatment method for acute leukemia.
OBJECTIVE: To assess the clinical efficacy and complications of HLA-identical sibling allo-PBSCT for acute leukemia.
METHODS: A total of 25 patients with acute leukemia received HLA-identical sibling allo-PBSCT. All cases included 20 cases with acute myeloid leukemia and 5 cases with acute lymphocytic leukemia. Conditioning regimen consisted of busulphan and cyclophosphamide or cyclophosphamide and total body irradiation. Mycophenolate mofetil in combination with cyclosporine and methotrexate was used to prevent graft-versus-host disease.
RESULTS AND CONCLUSION: Hematopoietic reconstitution was observed in all patients during the follow-ups of 2-80 months. The time of neutrophil count ≥0.5×109/L and platelet ≥20×109/L was at day 12.84 (ranged 10-18 days) and day 20.32 (ranges 10-37 days), respectively. The main complications included 12 cases of sepsis, 9 cytomegalovirus infections, 3 herpes zoster virus infections, 10 acute graft-versus-host disease, 11 chronic graft-versus-host disease and 4 hemorrhagic cystitis. After follow-ups, 17 patients (68%) were in disease-free survival and 8 cases died. HLA-identical sibling allo-PBSCT as a treatment for acute leukemia is safe and efficient.

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