异基因外周血造血干细胞移植治疗白血病

背景:异基因外周血造血干细胞移植是治疗白血病的有效手段。目的:比较血缘与非血缘供者异基因外周血造血干细胞移植治疗白血病的造血重建、免疫重建、感染、移植物抗宿主病及疗效。方法:选择接受异基因外周血造血干细胞移植治疗的白血病患者45例,其中30例患者接受血缘供者造血干细胞移植(血缘组),15例患者接受非血缘供者造血干细胞移植(非血缘组)。结果与结论:①造血重建:血缘组白细胞和血小板重建时间均快于非血缘组(P<0.05)。在移植后30~40d植活证据指标测定提示异体造血干细胞在受者体内完全植活。②T细胞重建:两组移植后各时间点T细胞重建差异无显著性意义。③感染发生率:两组移植后早期感染发生率,急、慢性移植物抗宿主病发生率差异无显著性意义(P>0.05)。④白血病复发:两组移植后复发率差异无显著性意义(P>0.05)。⑤无病生存:两组移植后2年无病生存率差异无显著性意义(P>0.05)。表明血缘供者异基因外周血造血干细胞移植后的造血重建较非血缘供者迅速,但两者间移植后T细胞重建、感染发生率、移植物抗宿主病及无病生存并无差异。

Transplantation of allogeneic peripheral blood hematopoietic stem cells for treatment of leukemia

BACKGROUND: Allogeneic peripheral blood hematopoietic stem cell transplantation is an effective method for treatment of leukemia. OBJECTIVE: To evaluate haemopoietic reconstitution, immune reconstitution, infection, incidence of graft-versus-host disease (GVHD) and other complications between related transplantation group and unrelated donor transplantation group. METHODS: Forty-five patients received allogeneic peripheral blood hematopoietic stem cell transplantation for treatment of leukemia. Clinical results of 30 patients receiving related transplantation were compared to those of 15 patients receiving unrelated donor transplantation. RESULTS AND CONCLUSION: The related transplantation group resulted in a significantly shorter time to neutrophil and platelet engraftment compared to the unre-lated donor transplantation group (P < 0.05). At 30-40 days after transplantation, en-graftment test revealed that allogeneic hematopoietic stem cells were implanted successfully into recipients. T cell reconstitution between the two groups differed slightly without significant difference at different time after transplantation. There were no significant differences in incidence of early-stage infection, acute and chronic GVHD between related donor transplantation group and unrelated donor transplantation group (P > 0.05). There were no significant differences in relapse of leukemia (P > 0.05) and 2-year disease free survival between related donor trans-plantation group and unrelated donor transplantation group (P > 0.05). These findings suggest that haemopoietic reconstruction in the related donor transplantation group was more rapid than in the unrelated donor transplantation group, but there were no significant differences in T cell reconstruction, incidence of infection and GVHD, and 2-year disease free survival rate between related donor transplantation group and unrelated donor transplantation group.