异基因造血干细胞移植治疗恶性组织细胞病

目的 探讨异基因造血干细胞移植(Allo-HSCT)治疗恶性组织细胞病(MH)的方法和疗效. 方法 对1例MH患者进行Allo-HSCT,采用改良马利兰/环磷酰胺(Bu/Cy)预处理方案进行亲缘HLA全相合的外周血干细胞移植,移植物抗宿主病(GVHD)的预防采用环孢素A联合短疔程甲氨蝶呤的方案. 结果 患者移植后造血功能恢复顺利,中性粒细胞绝对数＞0.5×109/L时间为+20 d,Pt＞20×109/L时间为+27 d.患者+30 d行骨髓短串联重复序列(STR)-PCR检测显示为完全供者的基因型,移植后2个月发生Ⅱ度急性GVHD,加用泼尼松后病情得到控制,未发生慢性GVHD,随访至移植后8个月,造血功能恢复良好,病情处于持续完全缓解状态,仍在继续随访中. 结论 对符合传统意义上或WHO重新定义的MH患者,Allo-HSCT是一种有效的根治方法.

The treatment of allogeneic hematopoietic stem cell transplantation for malignant histiocytosis

Objective To explore the treatment and effect of allogeneic hematopoietic stem cell transplantation(Allo-HSCT)for malignant histiocytosis(MH).Methods One patient with MH received Allo-HSCT.The patient received conditioning regimens of improved busulfan/cyclophosphamide and relative HLA-identical periphend blood stem cell transplantation.Graft versus host disease(GVHD)prophylaxis consisted of cyclosporin-A(CsA)and short course of methotrerate.Results The hematopoietic stem cell was transplanted successfully.The time of absolute neutrophil count＞0.5×109/L and Pt＞20×109/L was +20 d and+27 d respectively.The DNA fingerprinting showed engraftment by short tandem repeated-PCR (STR-PCR)in +30 d.The grade Ⅱ acute GVHD occurred in the 2nd month after transplantation,and it was controlled by prednisone.None of the chronic GVHD was observed.The patients was followed up for 8 months after Allo-HSCT,and the state of illness retained continuous complete remission.Conclusion The treatment of Allo-HSCT is an effective radical cure method fo trraditional or world health organization redefined patients with MH.