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目的:评价异基因外周血干细胞移植(Allo-PBSCT)治疗血液肿瘤的疗效。方法:用Allo-PBSCT治疗血液肿瘤患者52例[急性淋巴细胞白血病(ALL)11例,急性髓系白血病(AML)12例,慢性粒细胞白血病(CML)29例]。预处理方案为含TBI(21例)与不含TBI的高剂量化疗方案(31例),采用环孢素加骁悉加甲氨喋呤(MTX)常规预防性控制移植物抗宿主病,非亲缘关系移植加用抗胸腺细胞球蛋白(ATG)。结果:52例患者移植后造血功能均重建,急性移植物抗宿主病(aGVHD)发生率23.1%,慢性移植物抗宿主病(cGVHD)发生率21.2%,其中局限型占15.4%;9例患者于移植后1～16月分别死于移植物抗宿主病、感染和疾病复发或进展,35例患者已PFS3～46个月,ALL-首次完全缓解(CR1)9例,无病存活(DFS)5例,带病生存2例,死亡2例,ALL-不缓解(NR)2例,死亡2例;AML-CR18例,DFS6例,带病生存2例,AML-CR24例,DFS2例,带病生存1例,死亡1例;CML(慢性期)22例,DFS19例,带病生存2例,死亡1例,CML(加速期)4例,DFS2例,带病生存1例,死亡1例,CML(急变期)3例,DFS1例,死亡2例。结论:异基因外周血干细胞移植是目前有可能治愈血液肿瘤的惟一方法。CML慢性期和急性白血病CR1后尽早选择异基因造血干细胞移植。
Objective: To evaluate the efficacy of allogeneic peripheral blood stem cell transplantation (Allo-PBSCT) in the treatment of hematological tumors. Methods: Allo-PBSCT was used in the treatment of 52 patients with hematological malignancies (11 with acute lymphoblastic leukemia (ALL), 12 with acute myeloid leukemia (AML) and 29 with chronic myeloid leukemia (CML)]. Pretreatment regimen consisted of high dose chemotherapy (n = 31) with TBI (n = 21) and without TBI. Conventional prophylactic control of graft-versus-host disease was performed using cyclosporine Plus Squalene plus methotrexate (MTX) Relationships transplantation with anti-thymocyte globulin (ATG). Results: The hematopoiesis was reconstructed in 52 patients. The incidence of acute graft-versus-host disease (aGVHD) was 23.1% and that of chronic graft-versus-host disease (cGVHD) was 21.2%, of which 15.4% The patients died of graft-versus-host disease, infection and disease recurrence or progression from 1 to 16 months after transplantation. 35 patients had PFS for 3-46 months, 9 cases of ALL-CRI, 9 cases of disease free survival (DFS) 2 cases of AML-CR, 2 cases of disease, 2 cases of AML-CR, 2 cases of DFS, 2 cases of AML-CR, 2 cases of DFS, 2 cases of AML-CR, 1 case died and 1 case died. There were 22 cases of CML (chronic phase), 19 cases of DFS, 2 cases of sickness, 1 case of death, 4 cases of CML (accelerated phase), 2 cases of DFS, 1 case of sickness and 1 case of death , 3 cases of CML (blast crisis), 1 case of DFS and 2 cases of death. Conclusion: Allogeneic peripheral blood stem cell transplantation is the only way to cure hematological tumors. Allogeneic hematopoietic stem cell transplantation is selected as soon as possible after CR1 in CML chronic phase and acute leukemia.