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目的评价自体(auto-)造血干细胞移植(HSCT)或异体(allo-)HSCT治疗慢性粒细胞白血病(CML)的临床疗效。方法57例CML接受HSCT治疗,其中8例采用净化auto-HSCT、39例相关allo-HSCT、10例无关allo-HSCT。预处理方案:32例接受全身放疗+环磷酰胺(TBI+CY)、24例改良BuCY(羟基脲、马利兰、阿糖胞苷、环磷酰胺)、1例MACC(马法兰、阿糖胞苷、环磷酰胺、环已亚硝脲)。移植物抗宿主病(GVHD)预防:相关移植环孢素A+甲氨蝶呤(CsA+MTX)、无关移植CsA+MTX+霉酚酸酯(MMF)+抗胸腺细胞球蛋白(ATG)方案。Kaplan-Meier生存模型评估移植后无病生存期。结果8例接受激活骨髓联合反义寡核苷酸或联合STI571体内外净化自体移植后,除1例死于移植中相关并发症外,其余均获得部分或完全细胞或分子遗传学缓解。49例allo-HSCT患者除1例死于肝静脉闭塞综合征(VOD)和1例移植前急变患者移植后无效,其余患者均获完全缓解。移植中感染发生率为33.3%,VOD发生率7.0%,出血性膀胱炎发生率22.8%,巨细胞病毒间质性肺炎8.8%,VOD、出血性膀胱炎和巨细胞病毒间质性肺炎均发生在异体移植患者。急性和慢性GVHD在相关与无关移植分别为41.0%和48.6%与40.0%和42.9%。移植后白血病复发率自体移植57.1%、异体移植12.8%。移植后5年无病生存率在自体与异体移植分别为
Objective To evaluate the clinical efficacy of auto-hematopoietic stem cell transplantation (HSCT) or allo-HSCT in the treatment of chronic myeloid leukemia (CML). Methods Fifty-seven CML patients underwent HSCT. Eight of them were treated with auto-HSCT, 39 with allo-HSCT and 10 with unrelated allo-HSCT. Pretreatment regimens: 32 patients underwent radiotherapy with systemic radiotherapy plus cyclophosphamide (TBI + CY), 24 with modified BuCY (hydroxyurea, marilan, cytarabine, cyclophosphamide), 1 MACC (melphalan, cytarabine, Cyclophosphamide, Central nitrosourea). Graft Versus Host Disease (GVHD) Prevention: Related Ciclosporin A + Methotrexate (CsA + MTX), Transplanted CsA + MTX + Mycophenolate Monex (MMF) + Anti-thymocyte Globulin (ATG) Protocol. Kaplan-Meier survival model to assess disease-free survival after transplantation. Results After 8 cases were treated with activated bone marrow combined with antisense oligonucleotide or STI571 in vitro and in vivo, all or part of the cells or molecular genetics were relieved except one case died of complications related to transplantation. In 49 patients with allo-HSCT, 1 patient died of hepatic veno-occlusive syndrome (VOD) and 1 patient with acute pre-transplant graft was ineffective. All other patients were completely relieved. The incidence of infection in transplant was 33.3%, the incidence of VOD 7.0%, the incidence of hemorrhagic cystitis 22.8%, cytomegalovirus interstitial pneumonia 8.8%, VOD, hemorrhagic cystitis and cytomegalovirus interstitial pneumonia occurred In allogeneic patients. Acute and chronic GVHD were 41.0% and 48.6% and 40.0% and 42.9%, respectively, in the related and unrelated transplants. The recurrence rate of leukemia after transplantation was 57.1% in autologous transplantation and 12.8% in allograft. Five years after transplantation, the disease-free survival rate in autologous and allograft were