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目的:观察外周血造血干细胞移植(peripheral blood stem cell transplantation,PBSCT)治疗血液病的疗效,探讨移植相关并发症的预防及处理。方法:回顾性分析本院2005年4月—2010年4月接受PBSCT的51例血液病患者的临床资料。其中8例患者(急性髓系白血病3例、急性淋巴细胞白血病1例、慢性粒细胞白血病2例、急性重度再生障碍性贫血1例、多发性骨髓瘤1例)采用异基因外周血造血干细胞移植(Allo-PBSCT),43例患者(淋巴瘤28例、急性白血病12例、多发性骨髓瘤3例)采用自体外周血造血干细胞移植(Auto-PBSCT)。结果:所有患者均成功获得造血重建,中性粒细胞计数≥0.5×109/L平均时间为12.1 d(7~16 d),血小板计数≥20×109/L平均时间为15.9 d(6~58 d);未发生严重移植物抗宿主病(graftversushost disease,GVHD),无移植相关死亡。中位随访时间28个月(1~60个月)。Auto-PBSCT组患者中有9例复发,8例死亡,复发率达20.9%;Allo-PBSCT组患者无复发以及移植相关死亡。结论:PBSCT造血重建快,移植相关并发症较少,是一种安全而有效的治疗血液病的方法。
Objective: To observe the therapeutic effect of peripheral blood stem cell transplantation (PBSCT) on blood diseases and to explore the prevention and treatment of complications related to transplantation. Methods: The clinical data of 51 patients with blood diseases receiving PBSCT from April 2005 to April 2010 in our hospital were retrospectively analyzed. Among them, 8 patients (acute myeloid leukemia in 3, acute lymphoblastic leukemia in 1, chronic myeloid leukemia in 2, acute severe aplastic anemia in 1, multiple myeloma in 1) were allogeneic peripheral blood stem cell transplantation (Allo-PBSCT) and autologous peripheral blood stem cell transplantation (Auto-PBSCT) was used in 43 patients (28 lymphoma, 12 acute leukemia and 3 multiple myeloma). Results: The hematopoietic reconstitution was successfully performed in all the patients. The average time of neutrophil count≥0.5 × 109 / L was 12.1 days (ranged from 7 to 16 days), and the average platelet count≥20 × 109 / L was 15.9 days d); no graft-versus-host disease (GVHD) and no graft-related death. The median follow-up time was 28 months (range 1 to 60 months). Nine patients recurred in the Auto-PBSCT group, and 8 patients died, with a recurrence rate of 20.9%. Allo-PBSCT patients had no recurrence and transplant-related death. CONCLUSION: PBSCT has the advantages of quick hematopoietic reconstitution, less complications related to transplantation and is a safe and effective method for treating hematological diseases.