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目的:评估以马利兰和环磷酰胺(Bu-CY2)为预处理方案的非亲缘异基因骨髓移植治疗骨髓增生异常综合征(MDS)的临床疗效。方法:对6例MDS患者进行非亲缘异基因骨髓移植术,以Bu-CY2为预处理方案,Bu 4 m g.k-g 1.d-1,-7 d~-4 d,CY 60 m g.k-g 1.-d 1,-3 d~-2 d。输入单个核细胞数(MNC)为3.38×108/kg(2.4×108/kg~4.6×108/kg),CD 34+细胞数5.81×106/kg(1.2×106/kg~8.5×106/kg),粒-巨噬细胞集落形成单位(CFU-GM)数2.88×105/kg(1.61×105/kg~4.56×105/kg)。以霉酚酸酯加环孢素A(C sA)和短程氨甲蝶呤(MTX)预防移植物抗宿主病,前列腺素E1脂质微球预防肝静脉阻塞病。结果:6例患者中性粒细胞≥0.5×109/L的中位时间为18 d(13~21 d),血小板≥20×109/L的中位时间为21 d(13~24 d)。经DNA短串联重复序列多态性分析和染色体检查,均为供者骨髓植活。早期死亡率为0,移植后随访时间为27个月(6~60个月)。目前实际无病生存6例,缓解期实际生存率100%。结论:以Bu-CY2为预处理方案的非亲缘异基因骨髓移植是治疗MDS的有效方法。
Objective: To evaluate the clinical efficacy of non-related allogeneic bone marrow transplantation with myelin and cyclophosphamide (Bu-CY2) as a treatment for myelodysplastic syndrome (MDS). Methods: Six noninvasive allogeneic bone marrow transplantation patients were treated with Bu-CY2 as a preconditioning regimen. Bu 4 m gk-g 1.d-1, -7 d -4 d, CY 60 m gk- g 1.-d 1, -3 d ~ -2 d. The number of mononuclear cells (MNC) was 3.38 × 108 / kg (2.4 × 108 / kg ~ 4.6 × 108 / kg) and the number of CD 34 + cells was 5.81 × 106 / kg ), CFU-GM 2.88 × 105 / kg (1.61 × 105 / kg ~ 4.56 × 105 / kg). Mycophenolate mofetil plus cyclosporin A (C sA) and methotrexate (MTX) in the prevention of graft versus host disease, prostaglandin E1 lipid microspheres to prevent hepatic veno-occlusive disease. Results: The median time of neutrophil≥0.5 × 109 / L was 18 days (13 ~ 21 days) in 6 patients and 21 days (13 ~ 24 days) of platelet≥20 × 109 / L. DNA short tandem repeat polymorphism analysis and chromosome examination, are donor bone marrow graft. Early mortality was 0 and follow-up after transplantation was 27 months (6 to 60 months). The actual disease-free survival in 6 cases, the actual response rate of 100%. Conclusion: Non-allogeneic allogeneic bone marrow transplantation with Bu-CY2 is an effective treatment for MDS.