HLA不全相合骨髓移植治疗白血病五例

为探讨应用亲属中ＨＬＡ不全相合供体骨髓移植治疗白血病的疗效，选择性应用ＨＬＡ１～２个位点不合的血缘供体骨髓移植治疗白血病５例，并长期随访观察其远期疗效。结果５例患者中有３例无病存活１３４０、１１６０和９００天以上，恢复了正常的生活、工作和学习，１例慢性髓性白血病患者无病存活３年，于嵌合造血状态下复发，正在供体淋巴细胞输注治疗中，１例表兄弟间２个位点不合移植患者因Ⅳ度移植物抗宿主病和配型不合综合征致死。认为ＨＬＡ不全相合的亲属供体骨髓移植治疗白血病是有应用前景的，然而对移植物抗宿主病的发生应予以足够的重视。

HLA mismatched bone marrow transplantation as an alternative treatment for leukemia: a report of 5 cases

In order to investigate the feasibility of HLA mismatched family marrow donor for treating the patients with leukemia, HLA one or two locus mismatched family marrow donor was used to treat 5 patients with leukemia and the long-term therapeutic effects were followed up in out-patients for 3 to 4 years. Three patients survived without diseases and with 100% of karnofy score more than 1 340, 1 160 and 900 days after transplant, respectively. One CML patient survived without disease over 3 years, now with hematological relapse in a situation of chimerism,and received donor lymphocyte infusion. One patient transplanted with HLA 2 locus mismatched cousin died of Ⅳ grade GVHD. One to two locus mismatched marrow donor is a good alternative one for treating leukemia patients of non-matched donor, but we should pay enough attention to the earlier occurrence of GVHD for this kind of transplant.