目的　探讨讨低剂量全身照射 (6 0 - 9 0Gy)联合强烈化疗后行自体外周血造血干细胞移植能否在儿童难治性白血病或实体瘤中取得良好疗效。方法　 2 1例患儿进入本文研究 ,男 14例 ,女 7例 ,年龄 3 5 - 12岁。基础疾病包括高危急性淋巴细胞白血病(CR1) 3例 ,急性淋巴细胞白血病二次缓解 5例 ,急性非淋巴细胞白血病 9例 ,非何杰金氏淋巴瘤Ⅳ期 2例。完全缓解后 6- 11个月采集外周血造血干细胞 ,用大剂量化疗或化疗与G CSF/GM CSF合用进行采集前的动员。预处理方案包括下列药物中 2 - 3种联合 :环磷酰胺、阿糖胞苷、司莫司丁、足叶乙甙、去甲氧柔红霉素 ,并加用全身照射 (6 0 - 9 0Gy)。结果　所有病例在约 +7天出现严重骨髓抑制 ,外周血白细胞在 +4 8± 2 9天降至 0 ,血小板在 +9 0± 2 6天降至 2 0± 10 9/L以下。 17例外周血植入成功 ,另 4例分别于 +17、+2 0、+31和 +67天死于感染。白细胞升至 10×10 9/L ,中性粒细胞升至 0 5× 10 9/L ,血小板升至 2 0× 10 9/L的时间分别为 2 1± 12、2 6± 13和 2 7± 10天。随访研究显示 3例分别于 +5个月、1 5年和 2年 10个月复发 ,一例在 +8个月时死于颅内出血。 13例获得 2至 12年 (平均 6 7± 3 4年 )的无病生存。结论　我们的资料初步显示以强烈化疗与低剂 Objective To investigate whether low-dose whole-body irradiation (60-60 Gy) combined with intensive chemotherapy can achieve satisfactory results in children with refractory leukemia or solid tumors undergoing autologous peripheral blood stem cell transplantation. Method 2 1 case of children into this study, 14 males and 7 females, aged 35-12 years. The underlying diseases included 3 cases of high-risk acute lymphoblastic leukemia (CR1), 5 cases of secondary remission of acute lymphoblastic leukemia, 9 cases of acute non-lymphocytic leukemia and 2 cases of non-Hodgkin’s lymphoma stage IV. Peripheral blood stem cells were harvested 6- to 11 months after complete remission and mobilized prior to collection with high-dose chemotherapy or chemotherapy in combination with G CSF / GM CSF. The pretreatment regimen consisted of 2-3 combinations of cyclophosphamide, cytarabine, mimosudine, etoposide, daunorubicin plus systemic irradiation (60-9 0Gy). Results Severe myelosuppression occurred at about +7 days in all cases, with peripheral leukocytes falling to 0 on day +48 829 and platelets falling below 20 ± 109 / L on +9 0 ± 26 days. Seventeen cases of peripheral blood were successfully injected, and the other four died of infection at + 17, + 20, + 31 and + 67 days. Leukocytes rose to 10 × 10 9 / L, neutrophils rose to 0 5 × 10 9 / L, platelets rose to 20 × 10 9 / L time was 21 ± 12,2 6 ± 13 and 27 ± 10 days. Follow-up studies showed that 3 patients relapsed at +5 months, 15 and 2 years and 10 months, respectively, and one died of intracranial hemorrhage at +8 months. Thirteen patients were eligible for disease-free survival for 2 to 12 years (mean, 67 ± 34 years). Conclusions Our data initially show intense chemotherapy with low doses