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【目的】评价造血干细胞移植 (HSCT)治疗儿童白血病的疗效及合并症。【方法】非血缘相关脐血移植 (UD UCBT)治疗儿童白血病 5例 (AML 4例 ,HR ALL 1例 ) ;同胞外周血造血干细胞移植 (allo PBSCT)治疗CML及HR ALL各 1例 ;自体外周血造血干细胞移植 (auto PBSCT)治疗AML 2例。UD UCBT中 4例为HLA 5 / 6相合 ,1例为全相合。输入的脐血 (UCB)平均有核细胞数 (NC)为 6 2 9× 10 7/kg ,CFU GM为 0 17× 10 5/kg ,CD34+ 细胞数为 4 6× 10 5/kg。预处理主要以马利兰 (Bu)、环磷酰胺 (CY)、氟达拉宾 (Flu)和马法兰 (Mel)等组成的方案。【结果】 4例可评价的UD UCBT患儿中 3例完全植入 ,1例未植入者自体造血恢复 ,2例allo PBSCT患儿均完全植入。UCBT后外周血中性粒细胞绝对计数 (ANC)≥ 0 5× 10 9/L的中位时间为 +2 1d ,血小板 (PLT)≥ 2 0× 10 9/L的中位时间为 +40d。 2例allo PBSCT患儿外周血ANC≥ 0 5× 10 9/L的中位时间分别为 +10d和 +12d ,PLT≥ 2 0× 10 9/L的中位时间为 +11d和 +14d。 3例植入的UCBT者 2例分别发生Ⅰ度和Ⅲ度aGVHD。 2例allo PBSCT患儿分别发生Ⅱ度和Ⅲ度aGVHD。随访 2 5个月 ,2例auto PBSCT患儿均复发。allo HSCT 7例中 2例复发 ,2例死于移植合并症 ,3例无病存活至今。【结论】H
【Objective】 To evaluate the efficacy and complications of hematopoietic stem cell transplantation (HSCT) in the treatment of childhood leukemia. 【Methods】 5 cases of childhood leukemia were treated by UD UCBT (4 cases of AML and 1 case of HR ALL). Allo PBSCT was performed in 1 case of CML and HR ALL. The peripheral blood of autologous peripheral blood Two cases of AML treated by auto PBSCT. 4 cases of UD UCBT HLA 5/6 match, 1 case of full match. The average number of nucleated cells (NC) of cord blood UCB was 6 2 9 × 10 7 / kg, the CFU GM was 0 17 × 10 5 / kg and the number of CD34 + cells was 46 × 10 5 / kg. Pretreatment mainly in the plan of Maryland (Bu), cyclophosphamide (CY), fludarabine (Flu) and melphalan (Mel) and so on. 【Results】 Three of the 4 evaluable UD UCBT children were completely implanted. One patient without autologous hematopoiesis recovered, and 2 patients with allo PBSCT were completely implanted. The median time to peripheral blood neutrophil count (ANC) ≥ 0 5 × 10 9 / L after UCBT was +2 1d, and the median time to platelet (PLT) ≥ 20 × 10 9 / L was + 40d. The median time of ANC≥0 5 × 10 9 / L in peripheral blood of 2 cases of allo PBSCT was + 10d and + 12d respectively, and the median time of PLT≥ 20 × 10 9 / L was + 11d and + 14d. In 3 cases of UCBT, 2 cases had grade Ⅰ and Ⅲ aGVHD respectively. Two cases of allo PBSCT children with grade Ⅱ and Ⅲ aGVHD occurred. All patients were followed up for 2 5 months. Two children with auto PBSCT relapsed. Allo HSCT 7 cases of recurrence in 2 cases, 2 patients died of transplantation complications, 3 patients survived so far. 【Conclusion】 H