激活骨髓自体移植治疗白血病

Autologous transplantation with rIL-2 activated bone marrow for leukemias

为降低自体骨髓移植（ＡＢＭＴ）后的复发。采用重组白细胞介素２（ｒＩＬ－２）激活骨髓（ＡＢＭ）自体移植治疗白血病１１例。１０例预处理用ＭＡＣＣ（马法兰、阿糖胞苷、环磷酰胺和环已亚硝脲）方案、１例用全身照射＋环磷酰胺方案；移植后当天开始用ｒＩＬ－２（２～４）×１０￣５Ｕ／ｄ×（１５～３０天），０～＋５天开始用Ｇ－ＣＳＦ３００μｇ／Ｌ×（５～１５天）。结果：所有患者造血都得到重建，时间缩短；移植前５例未缓解患者移植后均获完全缓解（ＣＲ），２例在移植后１０个月与１３２天复发，其它９例持续ＣＲ至１９９６年３月，ＣＲ期为５６天～３０个月。２例出现皮肤移植物抗宿主病样表现；移植中感染发生率为３６．４％。结论：ＡＢＭ自体移植治疗白血病有效，并可能诱导移植物抗白血病效应，降低ＡＢＭＴ的复发率，联合应用Ｇ－ＣＳＦ和ＩＬ－２能加速移植后造血重建。

In order to reduce the relapse rate after autologous bone marrow Transplantation(ABMT),11 leukemia patients were transplanted with recombinant interleukin-2(rIL-2)activated autologous bone marrow.Ten patients were conditioned with MACC regimen,one with TBI-Cy.All patients received(0.84￣2.03)×108 activated bone marrow(ABM)cells/kg,(2￣4)×105U rIL2/d was administered from day 0 to day 15￣30 post ABMT.The results showed that 5 non-remissive patients achieved complete remission(CR)after transplantation.Nine of the 11 patients remained in CR at 46 days to 30 months,while the remaining 2 relapsed at 132 days and 10 months post-transplantation, respectively.Two patients developed graft·versushost-disease with mainly skin involvement.All patients reconstituted hematopoiesis.It was demonstrated that ABMT performed with ABM could generate graft-versusleukemia effect and reduce relapse rate.