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目的 :探讨造血干细胞移植治疗白血病和淋巴瘤的疗效、移植过程中的并发症及其预防和移植后的植活证据及微小残余病灶检测等问题。方法 :2例行同胞间异基因骨髓移植 (Allo- BMT)、5例行自体外周血干细胞移植 (APBSCT)。采用 Cs A+MTX预防 GVHD;PGE1+潘生丁预防 HVOD;以 APOB、SM7和D1 S80 三个位点多态性分析作为植活证据 ;以 bcr/abl、AML 1- ETO融合基因或 Ig H基因重排作为 MRD检测指标。结果 :2例 Allo- BMT均证实植活 ,并 MRD检测标志性基因检测转阴或表达减弱。 Cs A+MTX、PGE1+潘生丁分别是预防 GVHD和 HVOD的有效方法。结论 :白血病 Allo- BMT较 APBSCT有效 ,APB-SCT对淋巴瘤有较好的疗效。MRD的检测是估计预后的良好指标。
Objective: To investigate the efficacy of hematopoietic stem cell transplantation in the treatment of leukemia and lymphoma, the complications in the process of transplantation, the evidence of its prevention and transplantation after transplantation and the detection of minimal residual lesions. Methods: Allogeneic bone marrow transplantation (Allo-BMT) was performed in 2 siblings and 5 patients received autologous peripheral blood stem cell transplantation (APBSCT). Prevention of GVHD by Cs A + MTX, prevention of HVOD by PGE1 + dipyridamole, and APOB, SM7 and D1 S80 polymorphisms were used as evidence of graft survival. The bcr / abl, AML1-ETO fusion gene or IgH gene rearrangement As MRD detection index. Results: All of 2 cases of Allo-BMT were confirmed alive, and MRD detection of negative gene expression or negative expression. Cs A + MTX and PGE1 + dipyridamole are effective methods to prevent GVHD and HVOD, respectively. Conclusion: Allo-BMT of leukemia is more effective than APBSCT, and APB-SCT has good effect on lymphoma. MRD detection is a good indicator of prognosis.