异基因外周造血干细胞移植治疗造血系统恶性肿瘤的临床研究

目的:探讨异基因外周造血干细胞移植(A llo-PBSCT)治疗恶性血液病的疗效、造血重建及并发症情况。方法:对5例恶性血液病患者进行A llo-PBSCT治疗,包括急性中幼粒细胞性白血病(AML)3例、急性淋巴细胞性白血病(ALL)1例、非霍奇金氏淋巴瘤(NHL)1例,均为供受者HLA配型完全相合,其中同胞间移植4例、无关供者移植1例;4例采用清髓性预处理方案,1例为非清髓性预处理方案。结果:5例患者均获得造血重建,经血型、性染色体和短串联重复序列-聚合酶链反应检测证实均为供者型造血,中性粒细胞≥0.5×109/L的中位时间为移植后+12天,血小板≥20×109/L的中位时间为移植后+8天;5例患者均未发生肝静脉闭塞病;4例患者发生急性移植物抗宿主病(aGVHD);1例患者发生移植后单纯红细胞性再生障碍性贫血(PRCA),其余4例患者仍持续缓解(移植后145~470天)。结论:A llo-PBSCT是治疗恶性血液病的有效手段,尤其是对于复发难治性患者具有较好疗效。

Treatment of hematopoietic malignancies with allogeneic peripheral blood stem cell transplantation

Objective:To explore the clinical effect,hematopoietic reconstruction,and complications of allogeneic peripheral blood stem cell transplantation(Allo-PBSCT) on hematopoietic malignancies.Methods: Five patients were treated with Allo-PBSCT,including 3 acute myeloid leukemia(AML),1 acute lymphoblastic leukemia(ALL),and 1 nonHodgkin lymphoma(NHL).All patients were completely HLA matched,in four of which HSCs were obtained from sibling donors and one from unrelated donor.Four patients received myeloablative conditioning and one received non-myeloablative conditioning. Results: All five patients achieved hematopoietic reconstruction and were converted to full donor chimerism according to blood typing,sex chromosome analysis,and short tandem repeat sequence-polymerase chain reaction detection.The median time for neutrophil and platelet recoveries was post-transplantation +12 days and +8 days respectively.Acute graft versus host disease(aGVHD) occurred in four patients.Hepatic vein occlusive disease happened in no patients.Four cases remained in continuous complete remission after a follow-up of 145~470 days and one was complicated with post-transplanted pure red cell anaplastic anemia. Conclusion: Allo-PBSCT was an effective means for treatment of malignant hematopoietic diseases,especially for those relapse or refractory types.