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为了博采异基因BMT的GVL效应与ABMT不受供者限制的优点,作者用小鼠同基因混合H-2半相合异体骨髓移植,证实二者在一定比例混合移植后能耐受GVHD的发生且具明显的GVL效应。本研究作者报告了临床自体骨髓混合HLA半相合异基因骨髓移植,同时在体外高热及液体培养净化联合IL-2激活骨髓细胞,移植后又注射IL-2,以提高体内外对残留肿瘤细胞的净化效应,减弱GVHD反应和增强GVL效应。观察证实:移植过程是安全的,16例中无一例发生急性GVHD;近期疗效较好,移植后16例中5例复发,复发率为31.3％;11例未复发,其中7例随访7个月仍存活或且CCR,最长1例已无病存活35个月,余4例死于并发症和其它非血液病;16例除1例因早期死于HVOD外,余皆成功造血重建;对存活6例供受者性别不同患者性染色体分析发现移植后3例形成嵌合体,最长者已11个月余,目前仍在观察中。这一研究为临床恶性血液病治疗提供了一个新的途径。
In order to take advantage of the GVL effect of allogeneic BMT and the absence of ABMT restriction by the donor, the authors used a mouse homologous mixed H-2 haplotype allogeneic bone marrow transplantation to confirm that the two could tolerate GVHD after a certain proportion of mixed transplantation. And there is a clear GVL effect. The authors of this study reported a clinical autologous bone marrow-mixed HLA haploidentical allogeneic bone marrow transplantation. At the same time, in vitro hyperthermia and liquid culture purification combined with IL-2 activation of bone marrow cells, and then injected IL-2 after transplantation to enhance the in vivo and in vitro residual tumor cells Purifying effect, weakening the GVHD response and enhancing the GVL effect. Observation confirmed that: the transplantation process is safe, and none of the 16 cases experienced acute GVHD; the recent curative effect was good. 5 cases of recurrence occurred in 16 cases after transplantation, with a recurrence rate of 31.3%; 11 cases did not relapse, and 7 cases were followed up for 7 months. Survival or CCR, the longest one case has survived for 35 months without disease, the remaining 4 cases died of complications and other non-hematological diseases; 16 cases except 1 case died of HVOD early, all of them were successfully hematopoietic reconstruction; The analysis of sex chromosomes in six different sex-survivors of survivors revealed that chimeras were formed in 3 cases after transplantation. The longest ones were more than 11 months old and are still under observation. This study provides a new approach for the treatment of clinical hematological malignancies.