自体造血干细胞移植治疗恶性血液病疗效观察

Clinical study of autologous hematopoietic stem cell transplantation in the treatment of patients with malignant hemopathy

目的 观察自体造血干细胞移植（auto-AHSCT）治疗恶性血液病的疗效.方法 1994年10月至2009年5月采用AHSCT治疗的恶性血液病患者28例,中位年龄30（16～45）岁,其中急性髓细胞白血病（AML）19例,急性淋巴细胞白血病（ALL）4例,恶性淋巴瘤（ML）5例.外周血干细胞的动员均给予粒细胞集落刺激因子（G-CSF）5～10μg/kg.预处理方案主要为美法仑（Mel）140～160 mg/m^2＋环磷酰胺（CTX）120mg/kg＋阿糖胞苷（Ara-C）2g/m^2.结果 移植相关不良反应低,大部分（26例）患者造血重建快,中性粒细胞（ANC）＞0.5×10^9/L和Plt＞20×10^9/L的时间分别为12（8～38）和14（9～128）d,中位随访36（7～68）个月,3年无病存活19例（68%）,死亡9例（32%）[其中7例（25%）死于移植复发,2例（7%）死于移植后并发症].结论 AHSCT是一种治疗恶性血液病安全有效的方法.

Objective To observe the efficacy of autologous hematopoietic stem cell transplantation （auto-AHSCT） in treatment of malignant hemopathy. Methods A retrospective study was accomplished on the auto-AHSCT in the treatment of 28 patients with malignant hemopathy from Oct 1994 to May 2009. The median age of the patients was 30 （16-45） years. Among the 28 patients,19 cases were acute myelocytic leukemia （AML）,4 cases were acute lymphoblastic leukemia （ALL） and 5 cases were malignant lymphoma （ML）. Mobilization of peripheral blood stem cell was recieved by giving granulocyte colony-stimulating factor （G-CSF） 5-10 μg/kg. The patients were pretreated with melphalan （140-160 mg/m^2）,cyclophosphamide （120 mg/kg） and arabinosylcytosin （2 g/m^2）. Results Transplant-related side effects was less and the hematologic recovery of most patients（26 cases） was quite rapid. The days to stable neutrophil count of 0.5×10^9/L and platelet count of 20×10^9/L were 12（8-38） d and 14（9-128） d,respectively. The median followup duration was 36（7-68） months. 19 cases （68 %） achieved disease-free survival（DFS） and 9 cases （32 %）died in three years. Of the 9 death patients,7 cases （25 %） died of recurrence and 2 cases （7 %） died of posttransplant complications. Conclusion AHSCT is a safe and effective therapy method for malignant hemopathy.