骨髓腔内注射双份脐血移植治疗成人白血病临床初探

Preliminary clinical study of intra-BM injection after double unrelated cord blood transplantation in adult patients with leukemia

21例行双份非血缘脐血移植(DUCBT)成人白血病患者随机分为两组:实验组(11例)采用单份脐血IBMI联合单份脐血静脉输注(IV);对照组(10例)采用传统双份脐血均从静脉输注。观察两组输注副反应和总体疗效。IBMI过程安全耐受性好,全身不良反应明显低于IV(P<0.01)。两组植入率与植入时间比较差异无统计学意义。两组分别出现急性移植物抗宿主病(GVHD)5例和4例,慢性GVHD各1例。两组复发率、2年总生存率比较差异无统计学意义。实验组存活4例患者,其中3例为IBMI份脐血优势植入者。

21 adult patients with leukemia who received double unrelated cord blood transplantation（DUCBT） were divided into experimental group（n=11） and control group（n=10） randomly.In experimental group,patients received intra-bone marrow injection（IBMI） of one unit and intravenous injection（Ⅳ） of the other unit,while in control group patients received conventional Ⅳ of double units.The adverse reaction and the total effect were observed in two groups after the injection.IBMI was tolerated well and the systemic adverse reaction rate in experimental group was apparently lower than that in control group（P〈0.01）.There was no significantly difference in engraftment and hematopoietic recovery.Acute GVHD occurred in 5 patients in experimental group,while 4 patients in control group.Chronic GVHD occurred in 1 patients in both groups.There was no significantly difference between the experimental group and the control group in relapse rate and 2 years over survival.3 of 4 survival cases of IBMI＋IV group were with the IBMI unit.Despite safety and significantly lower systemic adverse reaction,IBMI technique in the setting of DUCBT do not show improvement in hematopoietic recovery and reduce risk of GVHD to the adult patients with hematopoietic malignancies.