异基因外周血造血干细胞移植治疗难治性白血病(附1例报告)

Allogeneic peripheral blood stem cell transplantation for refrac-tory leukemia

对 1例难治性急性粒 -单细胞白血病 (AML - M4 b)患者施行异基因外周血造血干细胞移植 (allo-PBSCT ) ,以 Cy/ TBI方案预处理后 ,输注 HL A完全相合的同胞供者经 G- CSF动员的外周血单个核细胞(PBMNCs) 9.0× 10 8/ kg,其中 CD34 + 细胞 6 .2 5× 10 6 / kg;移植物抗宿主病 (GVHD)的预防用 Cs A +MTX方案。结果 :+15天时 ,外周血中性粒细胞 >0 .5× 10 9/ L,血小板 >5 0× 10 9/ L;+30天时 ,外周血三系均完全恢复正常。仅有 度皮肤 GVHD发生。认为对于难治性白血病 ,如有 HL A相合供者 ,应及早行异基因造血干细胞移植 (allo-HSCT)特别是 allo- PBSCT。

A 34 year old female patient with refractory acute myelogenous leukemia(AML M4b)received allogereic peripheral blood stem cell transplantation(allo PBSCT) Conditioned by cyclophophamide and total body irradiation(Cy/TBI),then the recipient was infused with 9 0×10 8/kg of peripheral blood mononucleur cells(PBMNCs)including 6 25×10 6/kg of CD 34 + cells from a HLA matched related donor,which mobilized by G CSF CsA and MTX were given for prophylaxis against graft versus host disease(GVHD) Results showed that ANC>0 5×10 9/L and platelet>50×10 9/L on day+15,and peripheral blood recovered normally on day+30 There developed cutaneous acute grade I GVHD only It suggested that if HLA matched donors are available,it should be taken in time allogeneic hematopoietic stem cell transplantation(allo HSCT),especially allo PBSCT for patients with refractory leukemia,since the latter method might be associated with faster recovery of both hematopoietic and immunal functions of the recipients