异基因造血干细胞移植治疗血液肿瘤5例

Five cases of hematologic malignancies treated with allogeneichematopoietic stem cell transplantion

目的：探讨异基因造血干细胞移植对血液肿瘤的疗效。方法：采用异基因造血干细胞移植治疗血液肿瘤５例，包括２例第一次完全缓解（ＣＲ１）急性粒细胞白血病，１例ＣＲ１急性淋巴细胞白血病，１例急性粒细胞白血病复发和１例非霍奇金氏淋巴瘤Ⅳ期ＣＲ１。其中异基因骨髓移植（ａｌｏＢＭＴ）４例，异基因外周血造血干细胞移植（ａｌｏＰＢＳＣＴ）１例。所有病例均采用ＴＢＩ＋ＣＹ＋ＣＣＮＵ作预处理。结果：所有病例均移植成功。２例发生急性移植物抗宿主病（ａＧＶＨＤ），２例发生慢性ＧＶＨＤ（其中１例先有ａＧＶＨＤ）。１例未缓解病人移植后完全缓解，但于＋６９天死于间质性肺炎；１例（急淋）移植后１２个月死于复发，３例已分别无病生存３６、２６和１０个月。结论：异基因造血干细胞移植是根治白血病和淋巴瘤有效方法。

Purpose:To study the results of allogeneic hematopoietic stem cell transplantation for hematologic malignancies.Methods:5 patients with hematologic malignancies were treated with hematopoietic stem cell transplantation,including 2 case with AML in CR,a case with ALL in CR,a case with AML in NR and a case with NHL in CR,Among them 4 patients were treated with allogeneic bone marrow transplantation(allo-BMT),a patient with allogeneic peripheral blood stem cell transplantation(allo-PBSCT).All patients were conditioned by TBI+CTX+CCNU.Results:The hemopoietic function of all patients was recovered and had confirmed engraftment.Two cases presented a GVHD,Two cases presented c GVHD(one of them had presented a GVHD).One case who was in NR achieved CR after the BMT,but the patient died from severe interstitial pneumonia in day+69;one case (ALL) died from relapse in 12 months post-BMT;Three patients are leukemia free survivors for 36.26 and 8 months.Conclusion:For acute leukemia and NHL,allogeneic hematopoietic stem cell transplants are an effective therapy.The patient with PBSCT has a quicker hematopoietic reconstitution than BMT.