自体造血干细胞混合HLA半相合异基因骨髓移植治疗恶性血液病

目的: 观察自体造血干细胞混合HLA半相合异基因骨髓移植治疗恶性血液病的疗效及移植相关并发症. 方法: 分析1995-01/2003-01我院33例自体造血干细胞混合HLA半相合骨髓移植患者的临床资料. 结果: 17(51%)例患者发生了轻、中度口腔黏膜炎,重症出血性膀胱炎和肝VOD者各1例,白质脑病1例,全身放射治疗后发生脑水肿1例,1例移植期间出现结核性胸膜炎,并发间质性肺炎. 对可评估的性别不同的10例供受者性染色体分析发现3例(30%)移植后形成混合嵌合体,仅2例发生皮肤cGVHD. 随防42(6～96) mo,19例(57.6%)无病存活,4例(12.1%)移植相关并发症死亡,8例(24.2%)术后复发,2例(6.1%)发生了移植后MDS. 结论: 自体造血干细胞混合HLA半相合异体骨髓移植,能够有效诱导GVL效应,提高疗效,减少复发,且并无增加移植相关并发症.

Autologous hematopoietic stem cell mixed allogeneic HLA haploidentical bone marrow transplantation in the treatment of hematological malignancies

AIM: To investigate clinical outcome and the treatment related complications in patients with hematological malignancies undergoing autologous hematopoietic stem cell mixed allogeneic HLA haploidentical bone marrow transplantation. METHODS: We analyzed retrospectively the clinical data of 33 hematological malignancy patients from January 1995 to January 2003. RESULTS: Seventeen (51%) of all 33 developed mild or moderate oral mucitis,1 severe hemorrhagic cystitis,1 hepatic VOD,1 leukoencephalopathy, 1 cerebral edema after TBI,1 interstitial pneumonia due to tuberculous preurisy during transplantation.10 cases evaluable were analysed: 3 cases developed mixed chimera,and 2 cGVHD. With a median follow up of 42 months (range 6 to 96), 19 patients(57.6%) are still in disease free survival, 4(12.1%) patients died from transplantation related toxicity, 8(24.2%) relapsed post transplantation,2(6.1%) developed MDS post transplantation. CONCLUSION: These results indicate that autologous hematopoietic stem cell mixed allogeneic HLA haploidentical bone marrow transplantation can induce GVL effect and reduce relapse post transplantation,without an increased incidence of transplantation related mortality or toxicity.