HLA相合同胞异基因外周血造血干细胞移植治疗急性白血病

背景：HLA相合同胞间异基因外周血造血干细胞移植是治疗急性白血病的一种有效方法。目的：评价HLA相合异基因外周血造血干细胞移植治疗急性白血病的临床疗效及并发症。方法：25例急性白血病患者接受HLA相合同胞的异基因外周血造血干细胞移植,其中急性髓系白血病20例,急性淋巴细胞白血病5例。预处理方案为BU+CY方案或CY+TBI方案,移植物抗宿主病预防采用环孢素A+吗替麦考酚酯+短程甲氨蝶呤。结果：最短随访2个月,最长随访80个月。患者均获造血重建,中性粒细胞≥0.5×10⁹ L^-1的时间为10~18 d,血小板≥20× 10⁹ L^-1的时间为10~37 d。主要并发症：感染败血症12例,巨细胞病毒感染9例,带状疱疹病毒感染3例,发生急性移植物抗宿主病10例,慢性移植物抗宿主病11例,出血性膀胱炎4例。至随访结束,17例无病生存,8例死亡。提示HLA相合同胞异基因外周血造血干细胞移植是治疗急性白血病安全有效的方法。

HLA-identical sibling allogeneic peripheral blood stem cell transplantation in the treatment of acute leukemia

BACKGROUND: HLA-identical sibling allogeneic peripheral blood hematopoietic stem cell transplantation (allo-PBSCT) is an effective treatment method for acute leukemia.OBJECTIVE: To assess the clinical efficacy and complications of HLA-identical sibling allo-PBSCT for acute leukemia. METHODS:A total of 25 patients with acute leukemia received HLA-identical sibling allo-PBSCT. All cases included 20 cases with acute myeloid leukemia and 5 cases with acute lymphocytic leukemia. Conditioning regimen consisted of busulphan and cyclophosphamide or cyclophosphamide and total body irradiation. Mycophenolate mofetil in combination with cyclosporine and methotrexate was used to prevent graft-versus-host disease.RESULTS AND CONCLUSION:Hematopoietic reconstitution was observed in all patients during the follow-ups of 2-80 months. The time of neutrophil count ≥0.5×10⁹/L and platelet ≥20×10⁹/L was at day 12.84 (ranged 10-18 days) and day 20.32 (ranges 10-37 days), respectively. The main complications included 12 cases of sepsis, 9 cytomegalovirus infections, 3 herpes zoster virus infections, 10 acute graft-versus-host disease, 11 chronic graft-versus-host disease and 4 hemorrhagic cystitis. After follow-ups, 17 patients (68%) were in disease-free survival and 8 cases died. HLA-identical sibling allo-PBSCT as a treatment for acute leukemia is safe and efficient.