BU/CY预处理方案的异基因外周血干细胞移植治疗急性白血病

BU/CY as conditioning regimen with allogeneic peripheral blood stem cell transplantation (Allo PBSCT) in acute leukemia

目的 :观察 BU / CY预处理方案的异基因外周血干细胞移植 (Allo- PBSCT)治疗急性白血病的疗效。方法 :用 BU / CY预处理方案行 Allo- PBSCT治疗急性白血病 5例 ,其中急性淋巴细胞白血病 (AL L ) 4例 (CR13例 ,CR2 1例 ) ,急性非淋巴细胞白血病 (ANL L) 1例 (CR1 )。预处理方案 BU/ CY:BU4m g/ (kg· d)× 4,CTX6 0m g/ (kg· d)× 2。其中 2例 AL L 分别加米托蒽醌 40～ 5 0 m g。用 G- CSF10 μg/ (kg· d)× 5 d进行造血干细胞动员 ,分离单个核细胞 (MNC)中位数 6 .48× 10 8/ kg〔(3.5～ 7.0 )× 10 8/ kg〕。 CD34+细胞中位数 6 .6× 10 6 / kg〔(4.0～9.6 6 )× 10 6 / kg〕。结果 :全部患者移植后均重建造血 ,粒细胞 >0 .5× 10 9/ L,中位数 13d;血小板 >30× 10 9/ L,中位数为 13d;血小板 >5 0× 10 9/ L,中位数为 15 d。发生迟发性出血性膀胱炎 1例 ,白血病复发死亡 1例 ,CMV肺炎死亡 1例。其余 3例分别无病生存 11、9、7个月。结论 :Allo- PBSCT具有造血重建快 ,采集干细胞方便 。

Objective:To evaluate the efficacy of allo PBSCT in the treatment of acute leukemia.Method:Five patients with acute leukemia were treated by allo PBSCT with BU/CY as conditioning regimen.Started from June 1999.Four of them were ALL (CR 1 3, CR 2 1), one patient was ANLL (CR 1).The mediam age was 39 year (range 14～52 year).Conditioning regimen was BU/CY (BU 4 mg/(kg·d)×4, CTX 120 mg/(kg·d)×2,or BUCY+NVT 40 mg～50 mg/d in 2 patients with ALL.A combination of cyclosporine and methotrexate was administered to prevent acute GVHD.All donors received G CSF 10 μg/(kg·d)×5 days.One or two leukapheresis procedures were performed by CS 3000 plus blood cell separator to collect peripheral blood stem cells.Total numbers of mononuclear cells (MNC) of 6.48 ×10 8/kg recipient weight 〔range ( 3.5 ～ 7.0 ×10 8/kg〕, CD 34 + cells 6.6 ×10 6/kg〔range( 4.00 ～ 9.66 )×10 6/kg〕.Result:All patients were engrafted and hematopoietic reconstitution was rapid:neutrophils achieving 0.5 ×10 9/L at a mean of 13 day (range, 10～13 day), platelets >30×10 9/L at a mean of 13 day (range, 10～13 day).Plates >50×10 9/L at a mean 15 day.a GVHD occurred in 2 patients and localized cGVHD in 2 patients.Leukemia relapse occurred in one patient.Conclusion:Allo PGSCT can rapidly reconstitute hematopoiesis with incidences of aGVHD and cGVHD not more than that in BMT.