二次非清髓异基因造血干细胞移植治疗恶性血液病六例报告

Second non-myeloablative allogeneic stem cell transplantation for malignant hematological diseases:a report of 6 cases

目的 探讨 2次非清髓异基因造血干细胞移植 (NAST)治疗恶性血液病的疗效。方法 对 6例恶性血液病患者进行了主动或被动 2次NAST。结果 6例患者中第 1次NAST后发生排斥反应 3例 ,难治复发白血病呈混合嵌合性植入 3例。经 2次NAST ,5例均经过或不经过混合嵌合性植入达完全供者植入 ,无病存活 6～ 2 7个月 ,1例为混和嵌合性植入。发生移植物抗宿主病(GVHD)的患者少而轻 ,无移植相关性死亡。结论 主动 2次NAST是挽救难治复发或难植入、易排斥的恶性血液病患者生命的一条重要途径。

Objective To explore the clinical effects of second non-myeloablative stem cell transplantation (NAST). Methods Six cases of malignant hematological diseases receiving second NAST were retrospectively analyzed. Of them, 3 were suffered from transplant rejection after 1st NAST and the remaining 3 were stable mixed chimerism. Results Five of the patients achieved complete donor's chimerism and have been in disease-free-survival for 6～27 months. 1 GVHD occurred in only one of the 6 patients, and no transplant-related death happened. Conclusion Second NAST is effective for the treatment of patients with transplant rejection,and is also rational choice for those patients with refractory or relapse malignant hematological diseases.