外周血造血干细胞移植治疗儿童血液肿瘤的初期疗效观察

Short-term therapeutic effect of peripheral blood stem cell transplantation on pediatric hematological malignancies

目的 观察外周血造血干细胞移植 (PBSCT)治疗儿童血液肿瘤的初期疗效。方法 2 0 0 1年 5月至 2 0 0 2年 3月 ,以PB SCT治疗儿童血液肿瘤患者共 10例 ,其中 :ALL 5例 ;ANLL 1例 ;NHL3例 ;HD1例。除 1例同基因移植患儿采用G CSF(10 μg/kg ,1/d ,皮下注射 ,共 4d后开始采集 )对正常供体进行动员外 ,其他患儿均为自体外周血干细胞移植 ,动员方案为 :MOEP +G CSF。经 2～ 3次采集 ,获得MNC中位数为 5 4× 10 8/kg ,CD3 4+ 细胞为 6 1× 10 6/kg ,CFU M为 3 3× 10 5/kg。预处理方案 :Cy/TBI(8例 )或CEAC(2例 )。结果 所有患者移植后均重建造血。WBC >1 0× 10 9/L、中性粒细胞 >0 5× 10 9/L、PLT >2 0× 10 9/L ,分别为 (10± 3 )d、(11± 3 )d、(14± 5 )d。 1例患儿于移植后 3个月随访行常规化疗 ,因骨髓重度抑制继发感染死亡 ,1例患儿于移植后 4个月病情复发死亡。其余患者均无病存活 2～ 9个月 ,疗效仍在近一步随访中。结论 初期疗效显示 。

Objective To evaluate the short term therapeutic effect of peripheral blood stem cell transplantation (PBSCT) on the treatment of pediatric hematological malignancies. Methods Eight children with hematological malignancies were treated by PBSCT between April 2001 and March 2002. Five of them were ALL, 1 ANLL, 3 NHL, and one HD. Exceptin one patient who accepted synogeneic PBSCT (Syn PBSCT), the donor received G CSF at a dose of 10 micrograms/kg/day by subcutaneous injection for 5 days for PBSC mobilization, other patients who accepted autologous PBSCT (APBSCT), chemotherapy regimen(MOEP)followed by G CSF was used for PBSC mobilization. PBSCs were collected in two～three aphereses to a median mononuclear cells (MNC) of 5.4×10 8/kg, CD34 + cells 6.1×10 6/kg and CFU GM 3.3×10 5/kg. Eight patients received TBI/Cy and two patients received CEAC (CCNU, VP16, Ara C, Cy) as conditioning regimen respectively. Results All patients were engrafted and hematopoieteic reconstitution was rapid. The mean days of WBC recovery were 10 days up to >1.0×10 9/L,ANC 11 days up to 0.5>×10 9/L and PLT 14days up to >20×10 9/L. Of the patients, one died of infection caused by marrow depression 3 months after transplantation, one relapsed 4 months after transplantation, and 8 patients were still alive and disease free for 2～9 months. Conclusion PBSCT is a safe and effective therapeutic option in pediatric hematological malignancies.