急性髓性白血病混合造血干细胞移植后DLI+IL-2治疗的临床研究

目的:探讨急性髓性白血病(acute myeloid leukemia,AML)患者在接受自体外周血干细胞混合人类白细胞抗原(human leukocyte antigen,HLA)半相合异体骨髓移植(Mixed-HSCT)后,继予供体淋巴细胞输注+白介素2(DLI+IL-2)治疗的疗效。方法:对23例AML患者在完全缓解期采用TBI+VEMAC预处理方案,实施Mixed-HSCT。造血恢复后给予DLI+IL-2治疗1-8次。结果:所有患者均获得造血重建,中性粒细胞(ANC)≧0.5×109/L的中位时间为14(12-17)天,白细胞(WBC)≧4.0×108/L的中位时间为17(16-21)天。血小板(PLT)≧20×108/L的中位时间为21(19-23)天,PLT≧50×108/L的中位时间为25(24-27)天。+16至+21天时骨髓检查示恢复期骨髓象,无移植物抗宿主病(graft versus host disease,GVHD)发生,有6例形成混合嵌合体(46XX/46XY)。经过3年以上随访,存活15例,长期无病存活率(DFS)为65.2%。结论:Mixed-HSCT后应用DLI+IL-2治疗对急性髓性白血病患者的长期无病生存有积极意义。

Clinical study of treatment with donor lymphocyte infusion combined IL-2 after mixed hematopoietic stem cell transplantation for acute myelogenous leukemia

Objective:To approach efficacy of treatment with donor lymphocyte infusion combined IL-2(DLI+IL-2) after mixed hematopoietic stem cell transplantation(Mixed-HSCT) for acute myelogenous leukemia(AML).Methods: After chemotherapy,23 cases of patients who were diagnosed as AML received Mixed-HSCT and were treated with DLI+IL-2 for 1-8 times after hematopoietic reconstruction.Results: All patients obtained hematopoietic reconstruction.The median times of ANC recovery≧0.5×109/L and WBC recovery ≧4.0×109/L were 14(12-17) and 17(16-21)days,PLT recovery≧20×108/L and 50×108/L were 21(19-23) and 25(24-27) days,there were no any GVHD 6 patients form mixed chimerism(46XX/46XY).Disease-free survival(DFS) was 65.2%,with a follow-up over 3 years.Conclusion: Treatment with DLI+IL-2 after mixed-HSCT for acute myelogenous leukemia may increase DFS efficiently.