同基因造血干细胞移植治疗白血病的临床疗效

Clinical outcome of syngeneic hematopoietic stem cell transplantation for leukemia

目的探讨同基因造血干细胞移植（syn—HSCT）治疗白血病的疗效。方法对1例慢性髓性白血病一慢性期及1例急性髓性白血病M2型的患者进行了syn—HSCT的外周血干细胞移植，分别采用改良的马利兰／环磷酰胺及环磷酰胺／全身放疗方案作为预处理，未采用预防移植物抗宿主病（GVHD）措施。结果2例患者移植后造血恢复顺利，中性粒细胞绝对数（ANC）〉0．5×10^9／L时间分别为移植后8天和13天，血小板〉20×10^9／L时间分别为移植后8天和14天。移植后均未发生急性和慢性GVHD。分别随访至移植后12月和60月，慢性髓性白血病患者在骨髓细胞学及染色体水平完全缓解，在低BCL／ABL融合基因水平带病生存，急性髓性白血病M2型患者病情处于持续完全缓解状态，仍在继续随访中。结论Syn—HSCT相关并发症少，移植相关病死率低，复发率并不高，可能存在同基因移植物抗白血病作用，是治疗白血病的有效方法。

Objective To explore the effect of syngeneic hematopoietic stem cell transplantation （syn-HSCT） for the patients with leukemia. Methods 1 patient with chronic myeloid leukemiachronic phase（CML-CP） and 1 patient with acute myeloid leukemia M2（ AML- M2 ） received syngeneic peripheral blood stem cell transplantation. They received conditioning regimens of improved busulfan/cyclophosphamide and cyclophosphamide/total body irradiation respectively. The two patients did not receive prophy- laxis against graft-versus-host disease （GVHD）. Results The hematopoietic stem cell was transplanted successfully. The ANC and PLT were graftted respectively in ＋ 8 d, ＋ 13 d and ＋ 8 d, ＋ 14 d. The two patients did not develope acute and chronic GVHD. The patients were followed for 12 and 60 months after syn-HSCT respectively,the patient with CML-CP alive in the state of positive BCL/ABL fusion gene, but negative bone marrow cytology and chromosome. The patient with AML-M2 retained continuous complete remission after syn-HSCT. Conclusions Syn-HSCT has low relapse rate,low transplant-related complications and mortality. There may be syngeneic graft-versus- leukemia effect. It is an effective treatment for patients with leukemia.