外周血造血干细胞移植治疗恶性血液病临床研究

Clinical Studies on PBSCT in Treatment of Hematological Malignancies

报告HLA完全相合的同胞异基因外周血干细胞移植 (Allo -PBSCT)治疗急性白血病 3例 ;未净化的自体外周血干细胞移植 (Auto -PBSCT)治疗恶性淋巴瘤 2例的结果 .Allo -PBSCT供者经造血因子动员 .Auto -PBSCT患者经联合化疗加造血因子动员 .采集CD34 +细胞 6 8× 10 6～ 2 8× 10 6/kg ,经强烈化疗预处理后回输外周血干细胞 ,5例患者均造血重建 .患者中性粒细胞 >0 5× 10 9/L ,时间平均 11 6d ( 10～17d) ,血小板 >2 0× 10 9/L ,时间平均 2 6d ( 9～ 70d) .骨髓于 15～ 30d达增生活跃 .Allo -PBSCT患者于 15d经性染色体检测 1例 ,DNAD1S80 和 33 6位点检测 2例证实移植物植入成功 .3例移植前未完全缓解病例移植后达完全缓解 .提示外周血干细胞移植造血重建确切 ,造血重建快 。

Three cases of acute leukemia and two cases of malignant lymphomas were treated with HLA-identical siblings allo-peripheral blood stem cells(allo-PBSC) and unmodified auto-peripheral blood stem cells ( auto-PBSC) respectively. Allo-PBSCT donors were mobilized with hemotopoietic cytokines; auto-PBSCT patients were treated with chemotherapy plus hemothpoietic cytokines for mobilization. Blood cell separactor was used for collection of stem cells. One or two aphereses procedures were carried out until reaching the target value(CD 34 + cells 6 8×10 6～28×10 6 /kg). After high-dose chemotherapy, those patients were reinfused PBSC. Engraftment has been rapid in those patients: 11 6 days to PMN 0 5 10 9 /L ( range 10～17 days) and 26 days to platelets > 20×10 9/L ( range 9～70 days). During 15～30 days bone marrow aspirates showed hypercellarity, chromesome and DNA D 1 S 80 and 33 6 analyses showed successful engraftments were achieved in allo-PBSCT patients. I acute GVHD was observed in one alloPBSCT patients on the 25th day after refusion. Three partial remission patients achieved complete remission after transplantation. These results suggest that PBSCT has chorecteristics of rapid hemothopiotic reconstitution and fewer complications.