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目的比较无血缘关系供者外周血干细胞移植和骨髓移植在造血重建、T 细胞重建、感染、移植物抗宿主病(GVHD)及疗效等的差异。方法 53例白血病患者中,21例接受无血缘关系供者外周血干细胞移植(PBSCT 组),32例接受无血缘关系供者骨髓移植(BMT 组)。统计分析二者移植后白细胞和血小板重建时间、T 细胞重建、感染率、GVHD、白血病复发、无病生存(DFS)情况。结果PBSCT 组和 BMT 组移植后白细胞重建时间分别为(12.43±3.67)天和(16.16±2.99)天(P<0.01),血小板重建时间分别为(14.67±6.19)天和(21.23±8.25)天(P<0.01)。PBSCT 组和 BMT 组移植后1,3,6,9及12个月的 T 细胞重建差异无统计学意义。PBSCT 组和 BMT 组移植后早期感染率分别为42.86%和53.13%(P>0.05)。PBSCT 组与 BMT 组急性 GVHD 的发生率分别为61.90% 和71.885(P>0.05);在可统计的患者中,慢性 GVHD 的发生率在 PBSCT 组和 BMT 组分别为47.06%和43.48%(P>0.05)。PBSCT 组与 BMT 组移植后分别有4例和2例复发,二者复发率差异无统计学意义(P>0.05);PBSCT 组与 BMT 组移植后2年 DFS 率分别为(50.14±12.00)% 和(59.81±8.99)%,二者差异也无统计学意义(P>0.05)。结论无血缘关系供者 PBSCT 后的造血重建比BMT,但二者移植后 T 细胞重建、感染发生率、GVHD 及 DFS 的差异均无统计学意义。
Objective To compare the differences of hematopoietic reconstitution, T cell reconstruction, infection, graft versus host disease (GVHD) and curative effect between non-blood donor donors and peripheral blood stem cell transplantation. Methods Fifty-three patients with leukemia were treated with PBSCT and 21 with no blood donor donor BMT. Twenty-one of the 53 leukemia patients underwent PBSCT. Statistical analysis of leukocyte and platelet reconstruction time, T cell reconstruction, infection rate, GVHD, leukemia recurrence and disease-free survival (DFS) after transplantation were statistically analyzed. Results The time of leukocyte reconstruction in PBSCT group and BMT group was (12.43 ± 3.67) days and (16.16 ± 2.99) days respectively (P <0.01), and the platelet reconstruction time was (14.67 ± 6.19) days and (21.23 ± 8.25) days (P <0.01). There was no significant difference in T cell reconstitution at 1, 3, 6, 9 and 12 months after transplantation between PBSCT group and BMT group. The rates of early infection after PBSCT and BMT were 42.86% and 53.13% respectively (P> 0.05). The incidence of acute GVHD in PBSCT group and BMT group was 61.90% and 71.885, respectively (P> 0.05). Among the statistically significant patients, the incidence of chronic GVHD in PBSCT group and BMT group was 47.06% and 43.48% (P> 0.05). There was no significant difference in the recurrence rates between the PBSCT group and the BMT group (4 cases and 2 cases, respectively) (P> 0.05). The 2-year DFS rates of PBSCT group and BMT group were (50.14 ± 12.00)% And (59.81 ± 8.99)%, respectively, with no significant difference (P> 0.05). CONCLUSION: No hematopoietic donor PBSCT after hematopoietic reconstitution than BMT, but the T cell reconstitution, the incidence of infection, GVHD and DFS after transplantation between the two groups were not statistically significant.