异基因外周血造血干细胞移植治疗骨髓增生异常综合征23例疗效分析

目的观察异基因外周血造血干细胞移植(allo-PBSCT)治疗骨髓增生异常综合征(MDS)的疗效。方法对23例 MDS 患者行 HLA 相合的同胞间 allo-PBSCT,供者外周血采集前给予G-CSF 动员。输注外周血单个核细胞8.25(4.50～22.36)×10~8/kg,CD34~ 细胞5.59(1.57～12.22)×lO~6/kg 移植物抗宿主病(GVHD)的预防给予环孢菌素 A 加短疗程甲氨蝶呤,移植后1天( 1天)～ 28天给予霉酚酸酯。结果 23例患者中22例造血完全重建。中性粒细胞>1.0×10~9/L 和 BPC>50 × 10~9/L 的时间分别为 13( 11～ 17)天和 30( 13～ 102)天。移植相关死亡2例,移植后复发3例,现18例存活。 Kaplan-Meier 分析显示无病生存率、复发率分别为(77.8±8.7)%和(14.4±7.5)%。结论 Allo-PBSCT 治疗 MDS 治愈率高,复发率低。

Effectiveness analysis of allogeneic peripheral blood stem cell transplantation in 23 patients with myelodysplastic syndromes

OBJECTIVE: To analyse the outcome of allogeneic peripheral blood stem cell transplantation (allo-PBSCT) for myelodysplastic syndromes (MDS). METHODS: Twenty-three patients with MDS received G-CSF mobilized HLA-identical sibling allo-PBSCT. The numbers of mononuclear cells (MNC) and CD34+ cells were 8. 25 (4.50 -22.36) x 10(8)/kg and 5.59 (1.57 - 12.22) x 10(6)/kg respectively. CsA and shorten course MTX were used for graft-versus-host disease (GVHD) prophylaxis and MMF was given on + 1 d - +28 d posttransplantation. RESULTS: Among 23 patients, 22 achieved hematopoietic recovery. The median time of ANC > 1.0 x 10(9)/L and BPC > 50 x 10(9)/L were + 13 (+ 11 - +17) days and + 30 (+13 + 102) days respectively. Two patients died of transplant related complications and three died of disease relapse, while 18 patients survived. Kaplan-Meier analysis showed disease free survival and relapse rate were (77.8 +/- 8.7)% and (14.4 +/- 7.5)% respectively. CONCLUSION: Allo-PBSCT is an effective treatment for MDS patients.