异基因造血干细胞移植治疗血液病12例临床分析

目的:研究和探讨异基因造血干细胞移植(allo-HSCT)治疗血液病的临床疗效。方法:总结12例血液病患者经allo-HSCT及4例供者淋巴细胞输注(DLI)治疗的临床资料。结果:12例患者allo-HSCT后均获得造血重建,且经荧光原位杂交(FISH)或短串联重复-聚合酶链反应分析证实均为完全供者型造血,中性粒细胞(ANC)≥0.5×109/L的平均时间为11(10-19)天,血小板≥20×109/L的平均时间为22(12-44)天。5例发生急性移植物抗宿主病(GVHD),2例慢性CVHD。巨细胞病毒(CMV)感染2例,所有患者均未发生肝静脉阻塞综合征(HVOD)。4例allo-HSCT后出现复发后经用DLI治疗,3例又达完全缓解。12例中9例现仍持续完全缓解(移植后45-350天)。结论:异基因造血干细胞移植是治疗血液病的有效方法,尤其对于复发难治性恶性血液病有一定的疗效,移植后复发应尽早进行DII。

Treatment of Hematological Diseases with Allo-hematopoietic Stem Cell Transplantation

To explore the clinical effect of allo-hematopoietic stem cell transplantation (allo-HSCT) on hematological diseases. Methods:The clinical data of 12 cases undergoing allo-HSCT and 4 cases with donor lymphocyte infusion(DLI) were analyzed. Results: All patients had the hematopoietic regeneration, and converted to full donor chimerism by fluorescence in situ hybridization (FISH) or tandem repeats sequence. Of the 12 cases, five patients developed acute graft versus host disease (GVHD) and two chronic GVHD, and two cytomegalovirus(CMV) infections. Four cases appeared relapsed after allo-HSCT, and 3 cases got complete remission again after DLL Conclusion: Allo-HSCT is efficacious to treat the haematological diseases, especially relapsed malignant blood diseases, and DLI should be used in the patients relapsed after transplant.