HLA位点不全相合的异基因干细胞移植治疗白血病的临床分析

The clinical study of HLA mismatched allogenic stem cell transplantation for leukemia

目的探讨HLA不完全相合的造血干细胞移植治疗白血病的新方法。方法将8例白血病患者接受FBC预处理方案后行异基因粒细胞集落刺激因子(G-CSF)动员的骨髓和外周血干细胞联合移植,观察造血重建和移植相关的并发症情况。结果1例2位点不合患者植入失败,其余7例完全植入,白细胞恢复时间13.5d,血小板恢复15.1d,7例患者Ⅰ～Ⅱ度急性移植物抗宿主病(GVHD)发生率57.1%(4/7),局限性慢性GVHD发生率83.3%,未出现严重的心、肝和肺脏并发症。移植后6个月生存率62.5%。结论用FBC预处理方案和G-CSF动员后的骨髓和外周血干细胞联合移植的方法对于HLA不相合的移植安全有效。

Objective： To investigate the new method of HLA mismatched allogenic stem cell transplantation for leukemia. Method.. After receiving FBC conditioning, 8 patients with leukemia were treated with mismatched allogeneic hematopoietic stem cell transplantation of CSF-primed bone marrow plus peripheral blood stem cells. hematopoietic reconstitution and transplantation related complications were observed. Result： 1 patieat with two locus mismatched patient failed to engraft, the other 7 patients achieved full engraftment, the mean time of white blood cell count recovery was 13.5 d and that of platelet recovery was 15.1 d, The incidence of grade Ⅰ～Ⅱ acute GVHD was 57.1 % （4 of 7）, limited chronic GVHD occurred in 83.3% of patients, no patient developed severe heart, liver or lung toxicity. Conclusion： FBC conditioning regimen together with transplantation of CSF-primed bone marrow plus peripheral blood stem cells are effective and safe in HLA mismatched allogeneic stem cell transplantation.