伊马替尼联合异基因造血干细胞移植治疗慢性粒细胞白血病急淋变三例

 目的　探讨采用伊马替尼（STI571，商品名：格列卫）联合异基因造血干细胞移植（allo-HSCT）治疗慢性粒细胞白血病（CML）急淋变的疗效。方法　3例CML急淋变患者移植前后均口服伊马替尼（200～800 mg／d）。以改良全身照射（TBI）＋环磷酰胺（Cy）或改良白消安（Bu）＋Cy为预处理方案。结果　3例患者均造血重建。3例患者均发生急性移植物抗宿主病（aGVHD），1例发生慢性GVHD（cGVHD）。2例患者复发，但最终均获得缓解。3例患者均无病生存，中位随访时间28（11～35）个月。结论　伊马替尼联合allo-HSCT治疗CML急淋变，能够降低移植前白血病细胞负荷，有利于移植后复发的治疗，是一种安全有效的治疗方法。。

Analysis of 3 patients with allogeneic stem cell transplantation combined with imatinib for the treatment of lymphocytic blast crisis of chronic myeloid leukemia

Objective　To study the effect of imatinib combined with allogeneic stem cell transplanta－tion (allo-HSCT) in the treatment of lymphocytic blast crisis of chronic myeloid leukemia（CML-LBC）. Methods　Three CML-LBC patients were treated with imatinib(200 ～ 800 mg/d) before and after allo-HSCT. Preconditioning was improved total body irradiation (TBI) and cyclophosphamide (Cy) regimen or improved busulfan (Bu) and Cy regimen． Results　Engraftments were observed in all. All cases developed acute graft versus host disease (GVHD). One case developed chronic GVHD. Relapse was observed in two patients, but they acquired complete remission finally. Three patients all remained disease free surviva1 after a follow-up of median 28 (11~35) months． Conclusions　An effective and safe method for CML-LBC treatment of imatinib before and after transplantation could reduce the leukemic cell load before transplantation as well as conduce to the treatment of relapse.