改良预处理方案在单倍体移植治疗恶性血液病中的应

目的 探讨采用改良白消安-环磷酰胺预处理方案行单倍体移植治疗恶性血液病的疗效.方法 采用阿糖胞苷、白消安、环磷酰胺、甲环己亚硝脲及抗胸腺细胞球蛋白联合作为改良白消安-环磷酰胺预处理方案行单倍体移植治疗恶性血液病.结果 6例患者完全植入,＋12 d～＋20 d（回输干细胞前为一,回输干细胞后为＋WBC＞1.0×10^9/L,＋20 d～＋51 d PLT＞20×10^9/L,4例出现急性移植物抗宿主病,其中Ⅰ度1例,Ⅱ度2例,Ⅳ度1例,4例出现慢性移植物抗宿主病,无致命性感染发生,2例出现迟发性出血性膀胱炎,目前无恶性血液病存活13～63个月.结论 采用改良白消安-环磷酰胺顶处理方案行单倍体移植治疗恶性血液病是安全有效的方法.

Clinical study of haploidentical hematopoietic stem cell transplantation as a treatment of hematopoietic maligancies

Objective To study the effect of haploidentical hematopoietic stem cell transplantation as a treatment of hematopoietic malignancies.Methods Cytosine arabinoside(Ara-c), busulphan(Bu), cyclophosphamide (CTX) and methyl CCNU (MeCCNU) were used for preconditioning of patients; cyclophosphamide (CTX),rhG-CSF, cyclosporine A(CSA), mycophenolate mofetil (MMF), the anti-thymocyte globulin (ATG), IL-11 and methotrexate(MTX) were used for prophylaxis of acute graft versus host diseases to treat 8 cases of hematopoietic malignancies.Results All patients had complete engraftment.The median time of neutrophil recovery ＞ 1.0 ×109/L was 16.3 (12-20) days after transplantation.The incidence of grade Ⅲ ～ Ⅳ GVHD was 12.5%.All patients survived within a median follow-up of 34.7 months.Conclusions Haploidentical hematopoietic stem cell transplantation is a safe and effective treatment for hematopoietic malignancies with Ara-c, Bu, CTX, MeCCNU as preconditioning and with CTX, rhG-CSF, CSA, MMF, ATG, IL-11 and MTX as prophylaxis of aGVHD.