同胞间脐血移植成功治疗儿童难治性急性髓系白血病

Successful engraftment of HLA-identical sibling cord blood transplantation in a child with refractory acute myelogenous leukemia:case report and literature review

目的报道同胞间脐血移植(UCBT)成功治疗1例儿童难治性急性髓系白血病的疗效及治疗体会。方法急性髓系白血病M5a型8岁男性患儿1例,采用改良的白消安/环磷酰胺(BU/CY)方案预处理。回输人类白细胞抗原(HLA)配型完全相合胞妹的脐血干细胞,脐血有核细胞(NC)数:5.17×107/kg,其中集落形成细胞(CFC)数为10.33×104/kg,CD34+细胞数为1.25×105/kg。移植物抗宿主病(GVHD)的预防采用单用环胞素A(CsA)的方案。结果移植后+14d患者WBC>1.0×109/L,中性粒细胞绝对值(ANC)>0.5×109/L;+23dPLT>20×109/L,+35d性染色体检测显示为完全供者的染色体。移植后+85d未发生GVHD及其他并发症。结论UCBT是儿童高危白血病有效的治疗手段,而同胞间脐血移植则更为安全可靠。

Objective To report the treatment of HLA-identical sibling umbilical cord blood transplantation（UCBT）for a child with refractory acute myelogenous leukemia. Methods A 8 year old patient（make）with AML-M5a received UCBT from HLA-identieal female sibling donor. The conditioning regimen was modified BU/CY. 5. 17 ×10^7 NC/kg, 10. 33 ×10^4 CFC/kg, 1. 25 ×10^5 CD34^＋. cells/kg were transplanted. The prophylaxis regiment of graft-versus host disease（GVHD）was the cyclosporine（CsA） only. Results WBC〉1. 0×10^9/L,ANC2〉0. 5×10^9/L and PLT〉20×10^9/L were engrafted on ＋14d and ＋23d,respectively. Sex chromosome results showed engraftement by chromosome analysis on ＋35d. GVHD didn＇t occur until ＋ 85d. Conclusion UCBT is an effective way to treat childhood refractory leukemia, sibling UCBT may be a more effective and safe way to treat childhood leukemia.