伴多种高危因素的非血缘异基因外周血干细胞移植治疗急性淋巴细胞白血病

Unrelated-donor peripheral blood stem cell transplantation for acute lymphobalstic leukemia patient with multiple high disk factors

目的交流伴多种高危因素的非血缘异基因外周血干细胞移植(URD-PBSCT)经验。方法对伴有高龄、孕产史多、乙型肝炎、陈旧性肺结核、移植物抗宿主病、肺部真菌病等移植高危因素的急性淋巴细胞白血病患者行URD-PBSCT的过程进行总结分析。结果患者造血重建迅速,ANC>0.5×109/L,PLT>20×109/L的时间分别为+15d、+20d;+67d患者的血型由AB型转变为供者的B型;移植+38d出现Ⅰ度急性移植物抗宿主病,予甲强龙治疗后控制;+131d肺部真菌感染,经伏立康唑针治疗后好转;移植过程中肺部结核未复发,乙肝DNA拷贝持续<103。结论对具有高危因素的URD-PBSCT患者,移植相关并发症的防治致关重要。

Objeetive To communicate the experience of unrelated-donor peripheral blood stem cell transplantation（URD-PBSCT） for acute lymphoblastic leukemia（ALL） patient with multiple high disk factors. Methods An ALL patient with multiple high disk factors,such as great age, several childbearing history serum hepatitis carrier, old pulmonary tuberculosis, graft versus host disease,mycosis in bellows etc,accepted URD-PBSCT. Results The hematopoietic reconstitution of the patient was rapid, the time of ANC recovery were ＋lSd up to 0.5〉× 10^9/L,and PLT recovery were ＋20d up to 〉20× 10^9/L;the blood type AB were ＋ 67d change to type B;grade I acute graft versus host disease（aGVHD） was observed in ＋38d and was controlled by radiosone;mycosis in bellows had happened in ＋13 ld and treated with vorionazole;pulmonary tuberculosis was not relapsed and the copy of serfum hepatitis 〈10^3 persistently. Conclusion In URD-PBSCT,the prevention and cure of complication is very important.