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目的观察无血缘关系供者外周血干细胞移植治疗急、慢性白血病的疗效。方法2005年1月~2006年10月本科行无血缘关系供者造血干细胞移植治疗急、慢性白血病患者7例,所有供受者之间HLA高分辨配型全相合。预处理方案:CY+TBI方案4例、BU/CY方案3例。采用环孢菌素A加骁悉加MTX加ATG(即复宁)预防性控制移植物抗宿主病。结果移植+9~+22d(中位时间+13.2d),中性粒细胞>0.5×109/L;+14~+27d(中位时间+17.5d),血小板>20×109/L。2例于移植+38d和+56d发生Ⅱ度急性移植物抗宿主病,予甲强龙治疗后控制,4例发生慢性移植物抗宿主病,局限型2例,广泛型2例;无1例发生VOD及巨细胞病毒感染;移植相关不良反应CY+TBI方案与BU/CY方案未见差异;随访5~27个月,6例患者无病生存,1例死于本病复发;3例慢性粒细胞白血病bcr/abl融合基因检测转阴。结论无血缘关系供者外周血干细胞移植是一种有效的血液肿瘤治疗方法。
Objective To observe the therapeutic effect of peripheral blood stem cell transplantation in non-blood relative donor for acute and chronic leukemia. Methods From January 2005 to October 2006, seven unrelated donor hematopoietic stem cell transplantation patients were treated with acute and chronic leukemia, and all HLA donors were all matched with high resolution HLA typing. Pretreatment program: CY + TBI program in 4 cases, BU / CY program in 3 cases. Cyclosporin A plus Xiao Xitang MTX plus ATG (Fu Ning) prophylactic control of graft versus host disease. Results Transplantation of + 9 ~ + 22d (median time + 13.2d), neutrophils> 0.5 × 109 / L; + 14 ~ + 27d (median + 17.5d), platelets> 20 × 109 / L. 2 cases developed grade Ⅱ acute graft-versus-host disease on day 38 and day 56 after transplantation, controlled by methylprednisolone, 4 cases developed chronic graft-versus-host disease, 2 cases were localized and 2 cases were extensive. VOD and cytomegalovirus infection occurred. There was no difference between the CY + TBI regimen and the BU / CY regimen during the follow-up period of 5 to 27 months. Six patients were disease-free and 1 died of recurrence. Three Detection of myeloid leukemia bcr / abl fusion gene turned negative. Conclusion Non-blood donor peripheral blood stem cell transplantation is an effective hematological tumor treatment.