“微移植”治疗7例淋巴母细胞淋巴瘤/白血病的临床分析

本研究旨在观察Hyper-CVAD/MA化疗方案联合亲缘HLA单倍体相合供者G-CSF动员后外周血造血干细胞（G-PBHSC）输注组成的“微移植”治疗7例淋巴母细胞淋巴瘤/白血病（LBL/ALL）患者的疗效.研究对象为2009年8月至2012年9月第二炮兵总医院血液科收治的7例LBL/ALL患者.所有患者均接受了“微移植”治疗,首先给予患者Hyper-CVAD/MA方案化疗,在MA方案化疗结束后48 h给予亲缘HLA单倍体相合供者G-PBHSC输注,不进行移植物抗宿主病（GVHD）预防.截至2014年4月,中位随访41（20-57）个月.结果显示：7例患者共完成30个疗程“微移植”治疗,均获得完全缓解（CR）.“微移植”治疗主要的不良反应是骨髓抑制及相关感染;在治疗期间未观察到GVHD相关临床表现.随访截止时,5例无病存活,2例复发死亡.结论：“微移植”治疗LBL/ALL的疗效较好,安全性较高.

Clinical Analysis of Lymphoblastic Lymphoma/Leukemia Treated with Hyper-CVAD/MA Regimen Chemotherapy Combined with Haploidentical Hematopoietic Stem Cell Infusion

This study was aimed to investigate the efficacy of Hyper-CVAD/MA regimen chemotherapy combined with haploidentical hematopoietic stem cell infusion for the treatment of lymphoblastic lymphoma/leukemia （LBL/ ALL）. Seven patients with LBL/ALL were treated in Second Artillery General Hospital from August 2009 to September 2012. All patients received programmed infusions of granulocyte-colony stimulating factor （G-CSF）-mobilized family related HLA-haploidentical donor peripheral blood hematopoietic stem cell （G-PBHSC） after each of cycle of Hyper- CVAD/MA regimen chemotherapy without graft-versus-host disease （GVHD） prophylaxis. A total of four cycles of therapy were planned. The interval between each cycle of treatment was 8 to 12 weeks. By April 2014, the median follow-up time was 41 （20 -57） months. The results showed that the 7 patients totally received 30 cycles of treatment, and all patients achieved complete remissiom （CR）. The patients were generally well-tolerated to therapy, and the most significant toxicities of grade 3 to 4 neutropenia and thrombocytopenia developed in nearly all of the patients after each course of the Hyper-CVAD/MA regimen. No GVHD was observed in any of the patients during treatment. Up to now, 5 patients were still alive, 2 patients were died of relapse. It is concluded that the combination of chemotherapy and programmed haploidentical G-PBHSC infusion is a promising approach to the treatment of LBL/ALL.