HLA不全相合骨髓移植治疗白血病五例

HLA mismatched bone marrow transplantation as an alternative treatment for leukemia: a report of 5 cases

为探讨应用亲属中ＨＬＡ不全相合供体骨髓移植治疗白血病的疗效，选择性应用ＨＬＡ１～２个位点不合的血缘供体骨髓移植治疗白血病５例，并长期随访观察其远期疗效。结果５例患者中有３例无病存活１３４０、１１６０和９００天以上，恢复了正常的生活、工作和学习，１例慢性髓性白血病患者无病存活３年，于嵌合造血状态下复发，正在供体淋巴细胞输注治疗中，１例表兄弟间２个位点不合移植患者因Ⅳ度移植物抗宿主病和配型不合综合征致死。认为ＨＬＡ不全相合的亲属供体骨髓移植治疗白血病是有应用前景的，然而对移植物抗宿主病的发生应予以足够的重视。

In order to investigate the feasibility of HLA mismatched family marrow donor for treating the patients with leukemia, HLA one or two locus mismatched family marrow donor was used to treat 5 patients with leukemia and the longterm therapeutic effects were followed up in outpatients for 3 to 4 years. Three patients survived without diseases and with 100% of karnofy score more than 1 340, 1 160 and 900 days after transplant, respectively. One CML patient survived without disease over 3 years, now with hematological relapse in a situation of chimerism, and received donor lymphocyte infusion. One patient transplanted with HLA 2 locus mismatched cousin died of Ⅳ grade GVHD. One to two locus mismatched marrow donor is a good alternative one for treating leukemia patients of nonmatched donor, but we should pay enough attention to the earlier occurrence of GVHD for this kind of transplant. 