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目的探讨静脉滴注白消安(Bu)和氟达拉滨(Flu)作为预处理方案,进行异基因造血干细胞移植治疗髓系血液病的疗效。方法选取2003年10月至2005年4月成都军区昆明总医院血液科髓系血液病患者9例,其中急性非淋巴细胞白血病(ANLL)3例,慢性粒细胞白血病(CML)5例,骨髓增生异常综合征(MDS)1例,均进行同胞白细胞抗原(HLA)全相合异基因造血干细胞移植。预处理方案采用移植前第6天至移植前第3天静脉滴注白消安3.2mg/(kg.d),共4d;移植前第6天至移植前第2天静脉滴注氟达拉滨30mg/(m2.d),共5d。环孢素A和霉酚酸酯(骁悉)联合应用预防移植物抗宿主病(GVHD)。结果9例患者均成功植入,中性粒细胞>0.5×109/L的平均时间为12d;血小板(PLT)>20×109/L的平均时间为14d。中位观察时间为31个月。除轻微胃肠道反应外,无严重的预处理相关毒性,移植后1个月检测证实均为供者型完全植入。发生急性GVHD2例,慢性GVHD1例。9例患者中8例无病存活。结论静脉滴注Bu/Flu预处理方案,移植相关毒性小,治疗髓系血液病安全有效。
Objective To investigate the curative effect of intravenous infusion of busulfan and fludarabine as a preconditioning regimen for allogeneic hematopoietic stem cell transplantation in the treatment of myeloid hematopathy. Methods From October 2003 to April 2005, 9 cases of hematological myeloid hematological diseases in Kunming General Hospital of Chengdu Military Region were recruited. Among them, 3 cases were acute non-lymphocytic leukemia (ANLL), 5 cases were chronic myeloid leukemia (CML), 5 cases were bone marrow hyperplasia Abnormal syndrome (MDS) in 1 case, all sibling leukocyte antigen (HLA) allogeneic hematopoietic stem cell transplantation. Pretreatment program using pre-transplant 6 days before transplantation 3 days before the infusion of busulfan intravenous busulfan 3.2mg / (kg.d), a total of 4d; 6 days before transplantation to 2 days before transplantation by intravenous infusion fludalar Bin 30mg / (m2.d), a total of 5d. Cyclosporine A and mycophenolate mofetil combined to prevent graft versus host disease (GVHD). Results All 9 patients were successfully implanted. The average time for neutrophil> 0.5 × 109 / L was 12 days. The average time for platelet (PLT)> 20 × 109 / L was 14 days. The median observation time was 31 months. In addition to mild gastrointestinal reactions, no serious pretreatment-related toxicity, 1 month after transplantation confirmed that the donor type are fully implanted. 2 cases of acute GVHD and 1 case of chronic GVHD. Eight of the nine patients survived without disease. Conclusion Intravenous infusion of Bu / Flu preconditioning regimen is safe and effective in the treatment of myeloid hematopathy.