异基因干细胞移植用于实体瘤的治疗有很大的潜力。传统的清髓性造血干细胞移植采用大剂量化疗药物对受者进行预处理,虽然起到一定的杀伤肿瘤细胞作用,但增加了移植相关死亡率(transplant-related mortality,TRM)。随着对非清髓性预处理...异基因干细胞移植用于实体瘤的治疗有很大的潜力。传统的清髓性造血干细胞移植采用大剂量化疗药物对受者进行预处理,虽然起到一定的杀伤肿瘤细胞作用,但增加了移植相关死亡率(transplant-related mortality,TRM)。随着对非清髓性预处理的深入研究,人们将非清髓性造血干细胞移植用于实体瘤的治疗。与清髓性干细胞移植比较,非清髓性移植减轻了TRM,且拓宽了移植适应证。移植物抗宿主病(graft versus host disease,GVHD)是异基因移植后出现的毒性反应,甚至成为致命性的并发症。移植物抗肿瘤(graft versus tumor,GVT)效应是异基因移植治疗实体瘤的关键,而GVT效应常伴随GVHD的出现。因此,如何在保留GVT效应的同时降低GVHD是我们所面临挑战。目前,通过改变预处理方案、加强对移植物的处理、改变免疫抑制疗法等3种策略使用于GVHD的防治,取得了一定效果,为异基因造血干细胞移植治疗实体瘤带来了广阔前景。展开更多
The objectve of this investigation was to explore the use of nonmyeloablative allogeneic peripheral blood stem cell tranplantation for treatment of hematologic diseases. Six patients were included: 3 cases with acute ...The objectve of this investigation was to explore the use of nonmyeloablative allogeneic peripheral blood stem cell tranplantation for treatment of hematologic diseases. Six patients were included: 3 cases with acute leukemia in first complete remission(2 AML and 1 ALL), 2 severe aplastic anemias and 1 chronic myeloid leukemia in chronic phase. All of the 6 cases were received HLA-identical siblings donor peripheral blood stem cell transplantation after a nonmyeloablative conditioning. The donor cells were engrafted in all patients(3 cases were full engrafment of donor cells and 3 were mixed chimerism). Hematopoietic recovery was appeared in all of the cases(ANC recovered to more than 0.5×10 9/L and platelet count to more than 30×10 9/L on day 9 to day 21 and day 14 to day 28 after transplantation, respectively). Two patients developed Ⅲ or Ⅳ degree GVHD. Our preliminary results suggest that the procedure is more safe, efficient and less complications than myeloablative conditioning regimens and represents another new approach in the management of patients with hematologic diseases.展开更多
文摘异基因干细胞移植用于实体瘤的治疗有很大的潜力。传统的清髓性造血干细胞移植采用大剂量化疗药物对受者进行预处理,虽然起到一定的杀伤肿瘤细胞作用,但增加了移植相关死亡率(transplant-related mortality,TRM)。随着对非清髓性预处理的深入研究,人们将非清髓性造血干细胞移植用于实体瘤的治疗。与清髓性干细胞移植比较,非清髓性移植减轻了TRM,且拓宽了移植适应证。移植物抗宿主病(graft versus host disease,GVHD)是异基因移植后出现的毒性反应,甚至成为致命性的并发症。移植物抗肿瘤(graft versus tumor,GVT)效应是异基因移植治疗实体瘤的关键,而GVT效应常伴随GVHD的出现。因此,如何在保留GVT效应的同时降低GVHD是我们所面临挑战。目前,通过改变预处理方案、加强对移植物的处理、改变免疫抑制疗法等3种策略使用于GVHD的防治,取得了一定效果,为异基因造血干细胞移植治疗实体瘤带来了广阔前景。
文摘The objectve of this investigation was to explore the use of nonmyeloablative allogeneic peripheral blood stem cell tranplantation for treatment of hematologic diseases. Six patients were included: 3 cases with acute leukemia in first complete remission(2 AML and 1 ALL), 2 severe aplastic anemias and 1 chronic myeloid leukemia in chronic phase. All of the 6 cases were received HLA-identical siblings donor peripheral blood stem cell transplantation after a nonmyeloablative conditioning. The donor cells were engrafted in all patients(3 cases were full engrafment of donor cells and 3 were mixed chimerism). Hematopoietic recovery was appeared in all of the cases(ANC recovered to more than 0.5×10 9/L and platelet count to more than 30×10 9/L on day 9 to day 21 and day 14 to day 28 after transplantation, respectively). Two patients developed Ⅲ or Ⅳ degree GVHD. Our preliminary results suggest that the procedure is more safe, efficient and less complications than myeloablative conditioning regimens and represents another new approach in the management of patients with hematologic diseases.
