异基因造血干细胞移植治疗慢性粒细胞白血病的疗效观察

目的:分析异基因造血干细胞移植(allo-HSCT)治疗慢性粒细胞白血病(CML)的疗效。方法:回顾性分析2001年1月至2011年12月110例CML患者,慢性期93例、加速期8例、急变期9例,97例接受亲缘移植,13例接受非亲缘移植。接受改良Bu/Cy、全身照射联合Bu/Cy预处理方案分别为96、14例。接受环孢素(CsA)联合甲氨蝶呤(MTX)和CsA、MTX、麦考酚酯或抗胸腺细胞球蛋白预防移植物抗宿主病分别有86例和24例。结果:移植后5年感染率37.3%,巨细胞病毒血症发生率30.9%。急性移植物抗宿主病26例,慢性移植物抗宿主病46例。移植相关死亡(TRM)18例,10例死于GVHD,8例死于严重感染。结论:allo-HSCT是治疗CML有效手段,慢性期治疗效果好。

The clinical observation of allogeneic hematopoietic stem cell transplantation in the treatment of chronic myeloid leukemia

Objective: To analyze the efficacy of allogeneic hematopoietic stem cell transplantation(allo-HSCT) for chronic myeloid leukemia(CML).Methods: The clinical data of 110 CML patients undergoing allo-HSCT from Jan.2001 to Dec.2011 were retrospectively analyzed.Among those patients 93 cases were in chronic phase,8 cases were in accelerated phase and 9 cases were in blast phase.97 patients received related donor allo-HSCT,while 13 patients received unrelated donor allo-HSCT.96 patients received modified Bu/Cy protocol as preconditioning regimen and 14 patients received total body irradiation and Bu/Cy protocol.Cyclosporine(CsA) and methotrexate(MTX) were used to in 86 cases,while CsA,MTX,antihuman thymocyte globulin(ATG) or mycophenolate(MMF) were used in 24 cases.Results: Five years cumulative infection rate was 37.3%,CMV antigenemia was 30.9%.Acute GVHD occurred in 26 patients.Chronic GVHD occurred in 46 patients.The treatment-related mortality(TRM) was occurred in 18 patients,among which 10 cases died from GVHD,8 cases died from serious infection.Conclusion: Allo-HSCT is an effective way for the treatment of patients with CML,especially in the chronic period.