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目的探讨使用低强度Bu/Cy+ATG预处理方案进行异基因造血干细胞移植治疗恶性血液病的疗效。方法采用减低剂量的Bu/Cy+ATG方案,进行异基因造血干细胞移植治疗18例恶性血液病,预处理方案是:马利兰(BU)4 mg/(kg·d)×3,环磷酰胺(CY)60mg/(kg·d)×2,司莫司汀(Me-CCNU)450mg/(m2·d)×1,抗胸腺细胞球蛋白(ATG)3mg/(kg·d)×2。采用环孢素A+霉酚酸酯(MMF)+短程MTX预防GVHD。结果18例患者重建造血,中位随访时间22(3~40)个月,18例中无病存活10例,死亡8例,缓解期移植患者的存活率达66.7%。结论低强度的Bu/Cy预处理方案,移植相关毒性减小,该方法治疗恶性血液病安全可行。
Objective To investigate the efficacy of allogeneic hematopoietic stem cell transplantation for the treatment of hematologic malignancies using low-intensity Bu / Cy + ATG preconditioning. Methods A total of 18 cases of hematologic malignancies were treated with allogeneic hematopoietic stem cell transplantation using a dose reduction of Bu / Cy + ATG. The pretreatment regimen was 4 mg / (kg · d) × 3, cyclophosphamide (CY) ) 60mg / (kg · d) × 2, Me-CCNU 450mg / (m2 · d) × 1, anti-thymocyte globulin (ATG) 3mg / (kg · d) × 2. Cyclosporine A + mycophenolate mofetil (MMF) + short-term MTX to prevent GVHD. Results The hematopoiesis was reconstructed in 18 patients. The median follow-up time was 22 (3 ~ 40) months. There were 10 patients without disease and 8 patients died in the 18 patients. The survival rate was 66.7% in the remission patients. Conclusions The low intensity Bu / Cy preconditioning regimen reduces the toxicity associated with transplantation, and this method is safe and feasible for the treatment of hematologic malignancies.