三氧化二砷治疗高危骨髓增生异常综合征22例

1996年 4月至 1999年 8月 ,作者用三氧化二砷治疗骨髓增生异常综合征 (ＭＤＳ) 2 2例 ,取得了一定疗效 ,并且发现骨髓中早幼粒细胞比值较高的患者疗效较好 ,现报道如下。1　临床资料1 1　一般资料　 2 2例均为本院住院或门诊患者 ,符合ＭＤＳ的诊断标准[1] ,男 9例 ,女 13例 ,年龄 19～ 6 4岁。难治性贫血伴有原始细胞增多 (ＲＡＥＢ) 9例 ,转变中的ＲＡＥＢ(ＲＡＥＢ Ｔ)11例 ,慢性粒单细胞白血病 (ＣＭＭＬ) 2例。其中 18例曾接受1～ 3疗程化疗 ,12例服用过维甲酸 ,6例服用过维生素Ｄ3,4例用过干扰素 ,2例为初治患者。化疗者治疗时间为 2…     

80例原发性结外非霍奇金淋巴瘤的临床分析

恶性淋巴瘤(ML)大多数以淋巴结为首发，所谓“以淋巴结为基地的淋巴瘤(nodal based)”。另一些ML可首发在身体各部位的淋巴结以外的淋巴样组织及无淋巴组织的组织及器官，称原发性结外淋巴瘤(PENL)。因其临床表现复杂多样，早期诊断较困难，临床很易误诊或漏诊。为引起重视，本文对我院80例PENL进行临床分析，对本病的特点、诊断依据及治疗原则，进行总结以供参考。     

造血干细胞支持下大剂量LACE方案对27例难治复发性淋巴瘤疗效观察

目的:评价在造血干细胞支持下,LACE预处理方案对难治性、复发性淋巴瘤临床疗效.方法:自2001年3月至2003年7月对27例难治性、复发性淋巴瘤在造血干细胞支持下,应用LACE预处理方案:罗氮芥(L)200mg/m2,1次口服(移植前第7天),足叶乙甙(E)1g/m2,静脉点滴(移植前第7天),阿糖胞苷(A)2g/m2×d-1,静脉点滴(移植前第6、5天),环磷酰胺(C)1.8/m2×d-1,静脉点滴(移植前第4、3、2天),0天进行自体干细胞输注并进行随访观察.结果:27例患者均可耐受化疗,无移植相关死亡病例,并对移植后的患者进行随访观察,随访中位期14个月(7～35),6例复发,21例缓解.统计分析2年无瘤生存率可达70%,预计5年生存率可达55%.结论:对难治性复发性淋巴瘤,在造血干细胞支持下,LACE方案是较好的一种预处理方案.     

异基因移植CD56+CD16+量对移植物抗宿主病影响

目的 探讨异基因外周血干细胞移植供者CD56^＋CDl6^＋细胞的量对移植物抗宿主病（GVHD）的影响。方法 对16例白血病患者应用HIA配型完全相合同胞供者进行了外周血干细胞移植，并观察了输注CDl6^＋、CD56^＋量与GVHD的关系。结果 16例患者均早期获得了造血功能恢复，4例发生了Ⅰ度aGVHD，5例发生了Ⅱ度aGVHD，输注CDl6^＋、CD56^＋细胞的绝对量与Ⅱ度aGVHD发生呈负相关，相关系统为-0．67，Ⅱ度aGVHD所输注CD3^＋细胞绝对值、CD34^＋细胞绝对值无明显相关性。结论 异基因外周血干细胞移植GVHD的发生与输注CDl6^＋、CD56^＋细胞的绝对量相关。     

单倍型供者淋巴细胞输注治疗复发性急性白血病

Objective To evaluate the effect of haploidentical lymphocyte infusion on refractory and relapse acute leukemia. Methods The haploidentical donor lymphocyte infusion was used to treat for relapse acute myeloid leukemia 3 patients (M2 2 eases, M4 lcase), one relapse acute lymphocyte leukemia from April 2006 to October 2007. Four cases who had accepted secondly regimens were ineffective,after relapse. Collecting donor lymphocytes, parents children as donor supply in 3 cases, mother as donor supply one case. Before donor lymphocyte infusion patients received chemotherapy of different regimens. Donor haploidentical iymphocytes irradiated by 6-8 Gy radial were infused when patients white cell count was at the lowest after the chemotherapy. The average of infusion cells was 2.3 (1.4-3.1)×108/kg. Results One patient acquired complete remission and two patients were effective in three relapse acute myeloid leukemia. It was ineffective in relapse acute lymphocyte leukemia. No transfusion related graft versus host disease was observed. One patient has had herpes zoster virus infection. Conclusion Haploidentical donor lymphocyte infusion with chemotherapy are effective for refractory and relapse in acute myeloid leukemia, but the infused cell quantity and irradiated dosage must be further discussed.     

去除第11天甲氨蝶呤对单倍体造血干细胞移植患者发生急性移植物抗宿主病的影响

背景:环孢素联合4次短程甲氨蝶呤方案仍是目前公认的、经典的预防急性移植物抗宿主病方案,以往研究显示在同胞全相合移植后第11天是否应用甲氨蝶呤对于急性移植物抗宿主病的发生率没有影响,但减少第11天甲氨蝶呤对单倍体造血干细胞移植患者急性移植物抗宿主病发生率的影响仍不清楚.目的:探讨移植物抗宿主病预防方案中去除第11天甲氨蝶...     

单倍型供者淋巴细胞输注治疗复发性急性白血病

Objective To evaluate the effect of haploidentical lymphocyte infusion on refractory and relapse acute leukemia. Methods The haploidentical donor lymphocyte infusion was used to treat for relapse acute myeloid leukemia 3 patients (M2 2 eases, M4 lcase), one relapse acute lymphocyte leukemia from April 2006 to October 2007. Four cases who had accepted secondly regimens were ineffective,after relapse. Collecting donor lymphocytes, parents children as donor supply in 3 cases, mother as donor supply one case. Before donor lymphocyte infusion patients received chemotherapy of different regimens. Donor haploidentical iymphocytes irradiated by 6-8 Gy radial were infused when patients white cell count was at the lowest after the chemotherapy. The average of infusion cells was 2.3 (1.4-3.1)×108/kg. Results One patient acquired complete remission and two patients were effective in three relapse acute myeloid leukemia. It was ineffective in relapse acute lymphocyte leukemia. No transfusion related graft versus host disease was observed. One patient has had herpes zoster virus infection. Conclusion Haploidentical donor lymphocyte infusion with chemotherapy are effective for refractory and relapse in acute myeloid leukemia, but the infused cell quantity and irradiated dosage must be further discussed.     

骨髓移植后的腺病毒感染与出血性膀胱炎

骨髓移植后腺病毒感染引起的出血性膀胱炎在儿童多于成年人、HLA配型不相合高于相合者、有GVHD者高于无GVHD者。提示腺病毒感染是骨髓移植后引起出血性膀胱炎的一种多见并发症，应加强早期认识、早期诊断与治疗。阐述了腺病毒的生物学特征、感染特点、骨髓移植后出血性膀胱炎与腺病毒的关系及病毒的检测与治疗。