无血缘关系供者造血干细胞移植治疗恶性血液病的临床研究

Clinical studies of unrelated donor hematopoietic stem cell transplantation for patients with hematologic malignant diseases

目的探讨无血缘关系供者造血干细胞移植(UHSCT)治疗恶性血液病的疗效。方法对2003年3月至2006年12月军事医学科学院附属医院45例恶性血液病患者行UHSCT后无病存活率、移植相关病死率、移植后复发率、移植物抗宿主病(GVHD)的发生率、GVHD的严重程度及转归进行分析。结果45例患者中,3例于造血恢复前死亡。可评价的42例中,30例(71.4%)发生急性GVHD,其中Ⅱ度以上的急性GVHD9例(21.4%)。移植后复发死亡5例,感染死亡5例,GVHD相关死亡5例,现27例(64.3%)无病存活。Kaplan-Meier显示,无病存活率(58.5±13.2)%,复发率11.9%,Ⅱ度以上急性GVHD发生率21.4%。结论UHSCT治疗恶性血液病疗效肯定,为解决供者来源提供一个可选择的途径。

Objective To explore the efficacy of UHSCT for patients with hematologic malignant diseases. Methods Analysis was made regarding disease-free survival rate,transplant-related mortality, relapse rate of disease,incidence,severity and outcome of GVHD in 45 patients who received UHSCT in our hospital. Results Of 42 evaluable patients,thirty patients had GVHD （71.4%）and 9 patients had more than Ⅱ degree GVHD（21.4% ）. Five patients relapsed,5 patients died of infection and 5 patients died of acute GVHD ;27 （64. 3% ）patients had disease-free survival now. Kaplan-Meier analysis of leukemla-free survival, leukemia relapse and incidence of more than Ⅱ GVHD were （58. 5 ± 13.2 ）% , 11.9% and 21.4% respectively. Conclusion UHSCT is effective. It provides an alternative source for hematopoietic stern cell transplantation.