论文部分内容阅读
目的探讨改良马利兰-环磷酰胺2(Bu-CTX2)预处理方案在异基因造血干细胞移植(allo-HSCT)治疗恶性血液病的疗效。方法采用阿糖胞苷(Ara-c)、Bu或白消安针剂(白舒非)、CTX、甲基环己亚硝脲(Me-CCNU)及抗胸腺细胞球蛋白(ATG)联合作为改良Bu-CTX2预处理方案行allo-HSCT治疗恶性血液病15例。结果全部患者均顺利植入干细胞,白细胞>1.0×109/L的中位时间16.3天(+12～+20天),血小板>20×109/L的中位时间28.3天(+20～+51天);15例患者中出现全身急性移植物抗宿主病(aGVHD)Ⅳ度1例,aGVHDⅡ度2例,无Ⅲ度aGVHD发生,aGVHDⅡ～Ⅳ度的发生率20.0%,Ⅲ～Ⅳ度的发生率6.7%,随访中位时间为30.7(4～65)个月;无预处理相关死亡,无复发。结论采用改良Bu-CTX2预处理方案行allo-HSCT治疗恶性血液病是安全有效的方法 。
Objective To investigate the curative effect of Bu-CTX2 preconditioning with allo-HSCT in the treatment of hematologic malignancies. Methods The combination of Ara-c, Bu or Busulfan (CTX), CTX, Me-CCNU and ATG was used as a modified Bu-CTX2 pretreatment line allo-HSCT treatment of 15 cases of hematological malignancies. Results All the patients were successfully implanted with stem cells. The median time of white blood cells> 1.0 × 109 / L was 16.3 days (+ 12 ~ + 20 days) and that of platelets> 20 × 109 / L was 28.3 days Day). In 15 patients, there was 1 case of grade Ⅳ acute systemic graft-versus-host disease (aGVHD), 2 cases of aGVHD grade 2 and no grade Ⅲ aGVHD. The incidence of grade Ⅱ ~ Ⅳ aGVHD was 20.0%, Ⅲ ~ Ⅳ The rate was 6.7%. The median follow-up time was 30.7 (4-65) months. No pretreatment-related deaths and no relapse occurred. Conclusions Allo-HSCT with modified Bu-CTX2 pretreatment is a safe and effective method for the treatment of hematologic malignancies.