用BU3-CY预处理方案进行减量的异基因骨髓移植

THE EFFECTS OF BU3-CY CONDITIONING REGIMEN IN RI-BMT

目的 :探索 BU3- CY预处理方案在减低预处理剂量骨髓移植 (RI- BMT)中的作用。方法 :以 BU3- CY减低预处理剂量的方法对 7例白血病患者作 RI- HSCT,供者均为亲兄弟姐妹 (rela-tive sibling donor,RSD) ,其中有 3例为 HL A5 / 6位点相合者 ,输入 G- CSF动员的供者单个核细胞(MNC) 4× 10 8/ kg～ 8× 10 8/ kg,以 MTX,Cs A,MMF预防 GVHD。结果 :7例患者均成功植入 ,WBC上升到 1× 10 9/ L 为 +11天 (10天～ 15天 ) ,Plt上升到 2 0× 10 9/ L 为 +12天 (9天～ 17天 ) ,除口腔炎外 ,无明显的毒副作用。移植后 (11天～ 4 5天 )均有经 DNA检测证实的完全供者嵌合 (FDC) ,例 1于+2 0天时为混合嵌合 ,+45天时为完全嵌合。急性 GVHD3例 ,1例为 度 GVHD,+6 2天时死亡 ,2例为 度 GVHD治愈 ,3例有慢性 GVHD,2例为广泛性 ,1例为局限性。 6 / 7例无病存活 6个月 (2个月～ 12个月 )。结论 :BU3- CY的预处理方案可作为减低预处理剂量骨髓移植 (RI- BMT或 RI- HSCT)

Objective:To assay the effects of BU3 CY conditioning regimen in RI BMT or RI HSCT.Methods:Seven leukemia patients were treated by RI HSCT with BU3 CY conditioning regimen.BU 1 mg/g 1/6hr×3 days,CTX 60 mg/kg/d×2 days were given then transplanted with sibling donor's G CSF mobilized MNCs 4 8×10 8/kg.Three of them are HLA 5/6 loci matched,four are HLA 6/6 loci matched.GVHD prevention with CSA and MTX.Results:All the patients grafted successfully.WBC rose to 1×10 9/L on day+11(+10d-+15d).Platelets rose to 20×10 0/L on day+12(+9d-+17d).The side effects of conditioning regimen are mild.All patients had FDC on day11-day45,one patient had MDC on day20 and FDC on day 45.Three patients had acute GVHD,two with grade Ⅰ and restored,one with grade Ⅳ and died.There are 3 patients had chronic GVHD,one local,two extensive.The disease free survival(DSF) is 6 months (2-12 months).Conclusion:BU3 CY is a safety and effective conditionig regimen for RI HSCT.