白血病患者并发真菌肺炎行异基因移植7例临床分析

Clinical evaluation of allogeneic stem cell transplantation in 7 hematopathic patients complicated with aspergillus pneumonia

目的观察并发曲霉菌肺炎的白血病患者行异基因外周血造血干细胞移植的疗效及安全性。方法回顾性分析7例伴曲霉菌肺炎的白血病患者成功完成异基因外周血造血干细胞移植的过程。结果入组7例患者中,男4例,女3例,中位年龄22.8（13-37）岁,随访时间均大于6个月,移植后1个月复查患者嵌合体均为100%完全供者嵌合。移植后平均抗真菌治疗时间为3个月,7例患者肺部真菌感染全部达到显效,造血干细胞100%植入,无1例发生相关死亡。结论伴发曲霉菌肺炎的白血病患者采用有效的抗真菌治疗方案仍然可以接受异基因外周血造血干细胞移植,并不会影响供者造血干细胞植入,且患者耐受性良好,值得进一步研究。

Objective To investigate the efficacy and safety of allogeneic stem cell transplantation in treating malignant hematologic patients complicating with aspergillus pneumonia.Methods 7 patients（3 ALL,3 AML,1 CML-bc;4 male,3 female） complicating with aspergillus pneumonia were enrolled into this study.All patients achieved excellence or complete response before transplantation,3 patients underwent HLA-identical siblings transplantation,2 patient unrelated HLA-identical transplantation,2 patient HLA-haploidentical transplantation from parent.All patients had received continuous antifungal therapy during transplantation.The mean antifungal therapy time was 3 months after transplantation.Conditioning regimens consisted of busulfan（BU）,cyclophosphamide（CY）,teniposide（Vm26） and arabinosyl cytosine（Ara-C）.Follow up were done for more than 6 month.Results All recipients（100%） were complete chimerism one month after transplantation.The pulmonary cavity confirmed by radiology in 7 patients was all completely absorbed.No patient was dead.Conclusion The patients complicated with aspergillus pneumonia still has opportunity to undergo allogeneic stem cell transplantation,the aspergillus pneumoniathe will not influence the implantation of stem cell,and the patients were also well-tolerated.It deserves to be further investigated.