自体骨髓移植与混合HLA半相合异体骨髓的自体骨髓移植治疗恶性血液病的比较

目的 :提高自体骨髓移植 (ABMT)治疗恶性血液病的疗效 ,减少移植后疾病的复发。方法 :比较了液体培养净化的ABMT和混合 1/ 6量的HLA半相合异基因骨髓有核细胞的ABMT在恶性血液病中的应用 ,对ABMT组 11例和混合移植组 2 3例的疗效进行了随访和分析对比。结果 :ABMT组除 2例移植早期死亡 ,余 9例皆重建造血功能。混合移植组 4例早期死亡 ,余 19例皆成功造血重建。后者外周血三系细胞造血恢复均慢于前者 ,但无明显的统计学差异 (P >0 .0 1)。ABMT组无病存活 4例(36 .4% ) ,平均随访 48(34～ 92 )个月均CCR。混合移植组无病存活的 10例 (43.5 % ) ,中位随访 2 5 (16～ 6 5 )个月 ,仍存活 ,且均CCR。移植相关死亡ABMT组为 18.2 % ,混合移植组为 17.4%。ABMT组复发率为 44 .4% ,混合移植组为 31.6 %。混合移植组有 6例发生轻度皮肤型GVHD ,激素治疗后渐好转。二组病人皆未观察到急性GVHD。结论 :混合移植对恶性血液病的疗效优于ABMT ,并具有方法简便安全的特点。

Comparison of autologous bone marrow transplantation with mixed bone marrow transplantation in the treatment of patients with malignant blood diseases

Objective:[WT5BZ]To improve the effectiveness of autologous bone marrow transplantation(ABMT)and lower the disease relapse after graft.[WT5HZ]Methods:[WT5BZ]The clinical results of 11 cases of ABMT and 23cases of mixed HLA haplo-identical allogeneic and autologous marrow transplantation(MBMT)in the treatment of malignant blood diseases were followed up.Their data were analyzed and compared.[WT5HZ]Results:[WT5BZ]In ABMT group,all patients recovered hematopoieses except two died in early stage after transplantation;and in MBMT group,19 patients recovered hematopoieses except four early death.Peripheral blood cells were higher in ABMT than in MBMT,but no statistic difference was found.The free disease survival rates were 43.5% in MBMT and 36.4% in ABMT.The tumor relapse rates were 31.6% in MBMT and 44.4% in ABMT. Acute GVHD was not observed in both groups.[WT5HZ]Conclusion:[WT5BZ]MBMT is a more effective method than ABMT in the treatment of malignant blood diseases.