非血缘脐血移植治疗进展期慢性粒细胞白血病

 【摘要】　目的　回顾性分析非血缘脐血移植（UCBT）治疗进展期慢性粒细胞白血病（CML）的临床疗效。方法　14例进展期CML患者接受UCBT治疗，全部为清髓性预处理方案；环孢素A联合吗替麦考酚酯预防移植物抗宿主病（GVHD）。结果　13例造血顺利恢复。中性粒细胞绝对值≥0.5×109／L 的中位时间为22.8 d（14~32 d），血小板≥20×109／L的中位时间为37.8 d（27~52 d）。10例（78.6 %）发生急性GVHD，其中Ⅱ～Ⅳ度6例（46.2 %），生存时间＞100 d的11例患者中7例（63.6 %）发生慢性GVHD。2例复发。14例患者中9例生存，5年总生存率为64.3 %，5年无病生存率为57.1 %。结论　非血缘UCBT 是进展期CML的有效治疗手段。

Unrelated umbilical cord blood transplantation in the treatment of aggressive-phase chronic myeloid leukemia

Objective To retrospectively analyze the outcome of unrelated umbilical cord blood transplantation in the treatment of aggressive-phase chronic myeloid leukemia. Methods Fourteen consecutive patients with aggressive-phase chronic myeloid leukemia were treated with unrelated umbilical cord blood transplantation, thirteen patients were treated with myeloablative unrelated CBT and one patients were treated with nonmyeloablative unrelated CBT. All patients received standard cyclosporine A （CsA） and mycophenolate mofetil（MMF） as a graft-versus-host disease （GVHD） prophylaxis. Results 14 patients were all successfully engrafted. The median times for their neutrophil returning to ≥20× 109/L and for platelet returning to ≥20× 109/L were 22.8 days and 37.8 days, respectively. Acute GVHD occurred in 10 of 13 evaluable patients. The grading of acute GVHD was grade Ⅱ-Ⅳin 6 patients （46.2 %）.Chronic GVHD occurred in 7 of 11 evaluable patients（63.6 %）. Relapse occurred in 2 of 15 patients, lextramedullary relapse was included. 9 of 14 patients were alive and event-free after CBT. The probability of OS rate at 5 years was 64.3 %, the probability of DFS rate at 5 years was 57.1%. Conclusion Unrelated umbilical cord blood transplantation is effective in the treatment of aggressive-phase chronic myeloid leukemia.