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目的:对18例恶性血液病进行母供子非去T细胞性单倍体异基因造血干细胞移植(Allo-HSCT)治疗,探讨其疗效及毒性反应。方法:6例急性髓系白血病(AML-M23例,AML-M41例,AML-M5b2例),3例慢性粒细胞白血病(伴骨髓纤维化1例),8例急性淋巴细胞白血病(ALL),非霍奇金淋巴瘤(Ⅳ期B组)1例,以母亲为供者进行非去T细胞性单倍体Allo-HSCT。供者动员方案:G-CSF300μg/12h×5d后采集造血干细胞。输注D34+细胞(3.58~8.90)×106/kg。预处理方案为:MeCCNC250mg·m-2·d-1×1d,Ara-C4g·m-2·d-1×2d,Bu4mg·kg-1·d-1×3d,CTX1.8g·m-2·d-1×2d。ALL患者以全身放疗(TBI)代替Bu。以CsA、MMF、MTX和ALG预防移植物抗宿主病(GVHD)。结果:所有患者均顺利完成预处理。移植后发生急性GVHD16例、慢性GVHD10例,出血性膀胱炎1例。全部患者在移植后10~20d获造血重建。18例患者中12例存活。结论:非去T细胞性单倍体Allo-HSCT是治疗恶性血液病的一种安全、有效的方法;同时提示在以后的单倍体异基因造血干细胞移植中优先选择母亲供体,对降低GVHD的严重程度、提高移植成功率是有帮助的。
OBJECTIVE: To study the curative effect and toxicity of 18 cases of hematologic malignancies treated with allogeneic hematopoietic stem cell transplantation (Allo-HSCT). Methods: Six cases of acute myeloid leukemia (AML-M23, AML-M41 and AML-M5b2), 3 chronic myeloid leukemia (1 with myelofibrosis), 8 acute lymphoblastic leukemia (ALL) One case of non-Hodgkin’s lymphoma (stage Ⅳ, group B), non-T-cell haploid Allo-HSCT with mothers as donors. Donor mobilization program: G-CSF 300μg / 12h × 5d after the collection of hematopoietic stem cells. Infused D34 + cells (3.58 ~ 8.90) × 106 / kg. The pretreatment protocol was as follows: MeCCNC250mg · m-2 · d-1 × 1d, Ara-C4g · m-2 · d-1 × 2d, Bu4mg · kg-1 · d-1 × 3d, CTX1.8g · m-2 · D-1 × 2d. ALL patients with systemic radiotherapy (TBI) instead of Bu. Prevention of graft versus host disease (GVHD) with CsA, MMF, MTX and ALG. Results: All patients completed the pretreatment successfully. There were 16 cases of acute GVHD, 10 cases of chronic GVHD and 1 case of hemorrhagic cystitis after transplantation. All patients received hematopoietic reconstitution from 10 to 20 days after transplantation. Twelve of the 18 patients survived. CONCLUSIONS: Non-T-cell haploid Allo-HSCT is a safe and effective method for the treatment of hematologic malignancies. It is also suggested that the mother donor should be preferentially selected in future haploid allogeneic hematopoietic stem cell transplantation, The severity of transplantation to improve the success rate is helpful.