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为了探讨两份非亲缘供者脐血联合移植治疗成人血液系恶性肿瘤患者的造血重建及移植相关性并发症 ,对 1例成人慢性粒细胞性白血病患者进行两份非亲缘供者脐血联合移植。预处理采用白消安 /环磷酰胺 (Bu/Cy)方案。移植物抗宿主病 (GVHD)的预防采用霉酚酸酯 (MMF)联合环孢霉素 (CsA)和短程氨甲喋呤 (MTX )方案。移植总单个核细胞数为 4.63× 10 7/kg ,CD3 4 + 细胞数为 8.3 4× 10 5 /kg。采用PCR法测定患者外周血细胞短串重复序列 (STR)获取植入证据。结果表明 :患者于移植后 2 3天外周血中性粒细胞绝对值 >0 .5× 10 9/L ,移植后 3 3天外周血血小板 >2 0× 10 9/L ,移植后 47天血小板 >50× 10 9/L。移植后 ,患者Ph染色体转阴性 ,bcr/abl融合基因阴性。移植后 3 1天 ,46天及 71天查外周血STR显示其中 1份脐血完全植入。患者于移植后 13天出现Ⅱ度急性GVHD ,经治疗后消失。结论 :脐血联合移植可用于成人恶性血液病的治疗 ,多份脐血联合移植可能是解决单个核细胞数偏低问题的途径之一
To investigate the hematopoietic reconstitution and transplantation-related complications in two unrelated donor cord blood transplantation patients with adult hematological malignancies, one cohort of unrelated donor cord blood transplantation was performed on one adult chronic myeloid leukemia . Pretreatment with busulfan / cyclophosphamide (Bu / Cy) program. Prevention of graft-versus-host disease (GVHD) was performed with mycophenolate mofetil (MMF) plus cyclosporine (CsA) and methotrexate (MTX) regimens. The total number of mononuclear cells transplanted was 4.63 × 10 7 / kg, and the number of CD34 + cells was 8.3 4 × 10 5 / kg. PCR method was used to determine the short-term repeated sequence (STR) of peripheral blood cells in patients for obtaining evidence of implantation. The results showed that the absolute value of peripheral blood neutrophils was> 0.05 × 10 9 / L at 23 days after transplantation, peripheral blood platelets> 20 × 10 9 / L at 33 days after transplantation, platelets at 47 days after transplantation > 50 × 10 9 / L. After transplantation, patients with Ph chromosome negative, bcr / abl fusion gene negative. Peripheral blood samples of STR were found on day 31, day 46, and day 71 after transplantation. One cord of umbilical cord blood was completely implanted. Patients developed grade II acute GVHD 13 days after transplantation and disappeared after treatment. Conclusion: Umbilical cord blood transplantation can be used for the treatment of adult hematologic malignancies, and multiple cord blood transplantation may be one of the ways to solve the problem of low number of mononuclear cells