异基因骨髓联合外周干细胞移植术治疗白血病12例

12 patients with leukemia treated by allo-hematopoietic stem cell transplantation mixed with marrow and PBSC

目的探讨异基因骨髓联合外周干细胞移植术在白血病治疗中的应用,评价其疗效和安全性。方法12例白血病患者接受异基因骨髓联合外周干细胞移植,其中急性白血病8例,慢性白血病4例,供者均为同胞HLA配型全相合,预处理方案采用"改良BU/CY2",分两天采集外周干细胞及骨髓不做任何处理输注。移植后观察预处理毒副作用、移植相关并发症、植入情况、生存情况,并与同期白血病患者(单用化疗治疗)生存情况对比。最长随访时间25月。结果12例患者中1例早期死于肝静脉阻塞综合征,11例植入顺利并存活至今,生存率明显高于化疗组。1例发生Ⅰ度aGVHD,2例发生局限性cGVHD,发生时间分别为+150d、+130d发生肝静脉阻塞综合征1例,发生时间为+10d。毒副作用主要为恶心、呕吐、肝肾功能损伤。结论异基因骨髓联合外周干细胞移植术安全有效、并发症少,值得推广。

Objective To evaluate the outcome of 12 patients with leukemia undergoing allo -hematopoietic stem cell transplantation. Methods Twelve patients with leukemia, including 8 acute myeloid leukemia （ AML, CR1 ） ,4 chronic myeloid leukemia （CML,CP） received allo- geneic hematopoietic stem cells from HLA- identical siblings, BU -CY2 was used as conditioning regimen, marrow mixed peripheral blood stem cell was infused in 2 days, without any arranged. Research the side - effect and complication of conditioning regimen, grafting, survival rate after transplan- tation and compared with chemotherapy group in same period. Results In 12 cases, 1 case died of veno - occlusive disease（VOD） of the live,1 case have Ⅰ degree aGVHD,2 case occurred local cGVHD in ＋ 150 and ＋ 130 respectively, no graft failure. The survival rate of treat group is higher than control group, the difference is significant （ P 〈 0.01 ） side - effect of conditioning regimen is very slight. Conclusions Allo - hematopoietic stem cell transplantation mixed with marrow and PBSC is safe and effective as a treatment in leukemia patients.