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目的探讨采用改良Bu-CTX2预处理方案行异基因外周血造血干细胞移植(Allo-PBSCT)治疗CML的疗效。方法采用改良Bu-CTX2预处理方案的Allo-PBSCT治疗6例CML。预处理方案:阿糖胞苷(Ara-c)2~3g·m-2.d-1×2d(24h持续静滴),马利兰(Bu)4mg.kg-·1d-1×3d,环磷酰胺(CTX)50mg.kg-1·d-1×2d,甲基环已亚硝脲(MeCCNU)250mg·m-2.d-1×1d,抗胸腺细胞球蛋白(ATG)25mg·kg-1·d-1×4d。结果6例患者完全植入,+11d~+21d白细胞(WBC)>1.0×109·L-1,+11d~+23d血小板(PLT)>20×109·L-1。1例出现急性移植物抗宿主病(aGVHD)Ⅳ度,1例出现Ⅰ度aGVHD,3例出现慢性移植物抗宿主病(cGVHD),1例出现迟发性出血性膀胱炎(HC),目前已无病存活16~63个月。结论采用改良Bu-CTX2预处理方案的Allo-PBSCT治疗CML是安全有效的方法。
Objective To investigate the curative effect of Allo-PBSCT in the treatment of CML with modified Bu-CTX2 preconditioning. Methods Six cases of CML were treated with Allo-PBSCT with modified Bu-CTX2 pretreatment. Pretreatment protocol: Ara-c 2 ~ 3g · m-2.d-1 × 2d (24h continuous intravenous infusion), 4mg.kg- · 1d-1 × 3d, Cyclophosphamide (CTX) 50mg.kg-1 · d-1 × 2d, MeCNNU 250mg · m-2.d-1 × 1d, anti-thymocyte globulin (ATG) 25mg · kg- 1 · d-1 × 4d. Results Six patients were fully implanted with WBC> 1.0 × 109 · L-1 on day 11 + 21 days, PLT> 20 × 109 · L-1 on day 11, (A grade aGVHD in one case), chronic graft-versus-host disease (cGVHD) in three cases, and delayed bleeding hemorrhagic cystitis (HC) in one case. 63 months. Conclusion Treatment of CML with Allo-PBSCT with modified Bu-CTX2 preconditioning is a safe and effective method.