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目的 :探索非清髓异基因外周血干细胞移植 (NST)治疗不能耐受清髓性异基因造血干细胞移植的慢性粒细胞白血病 (CML)患者的疗效。方法 :将 5例CML患者中的 4例以全身放疗加氟达拉宾 ,1例以马利兰、氟达拉宾加抗人胸腺细胞免疫球蛋白为预处理方案 ,联合环孢霉素A、霉酚酸酯和 (或 )短程氨甲蝶呤预防移植物抗宿主病。结果 :5例均造血重建 ,3例完全供者型植入 ,2例混合型植入 ,其中 1例植入率持续低于 5 0 % ,经 2次清髓性异基因造血干细胞移植后达到完全供者型植入。 2例发生Ⅰ度急性移植物抗宿主病 ,1例发生Ⅳ度急性移植物抗宿主病 ,无慢性移植物抗宿主病发生。中位随访时间 5 (337)个月 ,无病生存 3例 ,死亡 2例。结论 :对不能耐受清髓性异基因造血干细胞移植的CML患者 ,NST是可行而有效的
Objective: To explore the efficacy of non-myeloablative allogeneic peripheral blood stem cell transplantation (NST) in the treatment of patients with chronic myeloid leukemia (CML) who can not tolerate myeloablative allogeneic hematopoietic stem cell transplantation. Methods: Four of five patients with CML were treated with systemic radiotherapy plus fludarabine, one with melilide and fludarabine plus anti-human thymocyte immunoglobulin as the pretreatment regimen. The combination of cyclosporin A and mildew Phenolic acid esters and / or teicoplanin prevent graft versus host disease. Results: All of the 5 patients underwent hematopoietic reconstitution, 3 underwent complete donor implantation and 2 underwent mixed implantation. The implantation rate in 1 patient continued to be lower than 50% after 2 myeloablative allogeneic hematopoietic stem cell transplantation Complete donor type implants. Two cases developed grade Ⅰ acute graft-versus-host disease, one case developed grade Ⅳ acute graft-versus-host disease, and no chronic graft-versus-host disease occurred. The median follow-up time was 5 (337) months, with 3 disease-free survival and 2 deaths. Conclusion: NST is feasible and effective in CML patients who can not tolerate myeloablative allogeneic hematopoietic stem cell transplantation