脐血造血干细胞移植治疗小儿慢性粒细胞白血病

目的 :研究脐血造血干细胞移植治疗小儿慢性粒细胞白血病的疗效及特点。方法 :给一例 12岁男性慢性粒细胞白血病慢性期的患儿移植HLA配型基本相合的同胞脐血。预处理选用BU CY方案 (马利兰 4mg·kg- 1 × 4d ,环磷酰胺 6 0mg·kg- 1 × 2d)。预防移植物抗宿主病 (GVHD)采用环孢霉素A(CsA)。移植有核细胞数为 2 0× 10 7·kg- 1 。结果 :移植后 2 2d(+2 2d)微卫星位点分析显示移植物植入成功 ,+2 5d骨髓显示造血开始重建 ,+42d中性粒细胞 >0 .5× 10 9·L- 1 ,+91dBCR ABL融合基因表达转阴 ,且受者血型由O型转为供者血型B型。随访 15 0d ,未发生急、慢性GVHD。结论 :脐血造血干细胞移植对小儿慢性粒细胞白血病有根治性治疗作用 ,它具有GVHD发生率低、程度较轻、重建造血慢等特点。

Cord blood stem cell transplantation in the treatment of juvenile chronic granulocytic leukemia

Objective To study the efficacy and characteristics of cord blood stem cell transplantation (CBSCT) in juvenile chronic granulocytic leukemia. Methods A 12 year old patient with chronic granulocytic leukemia in the chronic phase received CBSCT from an HLA compatible sibling. The pretreatment regimen was BU/CY (busulfan 4 mg·kg -1 ·d -1 ×4, cyclophosphamide 60mg·kg -1 ·d -1 ×2). Ciclosporin A (CsA) was given for the prophylactic treatment of acute graft versus host disease(GVHD). The patient received 2.0×10 7·kg -1 . Results DNA analysis showed that the engraftment was successful on the 22nd day; the hematopoietic function was reconstructed on the 25th day; neutrophils were more than 0.5×10 9·L -1 on the 42nd day; the expression of fusion gene BCR/ABL was negative, and the blood type of the patient changed from O to B on the 91st day. Neither acute nor chronic GVHD was found during the 150 days of follow up. Conclusion Cord blood stem cell transplantation is the best treatment for juvenile chronic granulocytic leukemia. It is characterised by a low morbidity of GVHD, but a slow hematopoietic reconstitution.