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目的 探讨异基因外周血干细胞移植 (allo PBSCT)治疗血液系统恶性疾病。方法 5 1例恶性血液病患者 ,中位年龄 34(5 .5～ 5 2 .0 )岁 ,接受了HLA配型相合或 1个位点不合的同胞供者PBSCT ,其中急性白血病 (AL) 31例 ,第 1次完全缓解 (CR1 )期 13例 ,第 2次完全缓解 (CR2 )期及以上 7例 ,未缓解或复发 11例 ,包括 2例异基因骨髓移植 (allo BMT)后复发 ;慢性粒细胞白血病 (CML) 12例 ,慢性期 5例 ,加速期 2例 ,急变期 4例 ,allo BMT后复发 1例 ;骨髓增生异常综合征 (MDS) 7例 ,RAEB及RAEB t各 1例 ,转为AL 5例 ;Burkitt淋巴瘤Ⅳ期 1例。采用全身照射 (TBI)或改良白消安预处理方案 ,预防移植物抗宿主病 (GVHD)采用经典环孢菌素 (CsA)加甲氨蝶呤 (MTX)方案。结果 所有患者均植活 ,中性粒细胞数恢复至≥ 0 .5× 10 9 L和BPC≥ 2 0× 10 9 L的中位时间分别为移植后第 14和 11天。发生Ⅱ度及以上急性GVHD 2 0例 (39% ) ,其中Ⅲ～Ⅳ度 2例 (4% )。 5 2 %的患者诊断慢性GVHD。死亡14例 ,8例死于移植相关合并症 ,6例死于复发。 37例长期存活 ,中位随访时间为 399(75～ 2 176 )d ,34例持续CR ,另 3例复发。 2年总生存率、无病生存率及复发率分别为 6 4 % ,6 1%及 2 4 %。结论 allo PBSCT治疗恶性血液病安全可靠
Objective To investigate allogeneic peripheral blood stem cell transplantation (allo PBSCT) treatment of hematological malignancies. Methods Fifteen patients with hematologic malignancies were enrolled in this study. Their median age was 34 (5.5-5.02 years). PBSCT was performed on HLA-matched or matched sibling donors, with acute leukemia (AL) 31 For example, there were 13 cases in the first complete remission (CR1) stage, 7 cases in the second complete remission (CR2) stage and above, 11 cases without remission or recurrence, including 2 allogeneic bone marrow transplantation (allo BMT) 12 cases of myeloid leukemia (CML), 5 cases of chronic phase, 2 cases of accelerated phase, 4 cases of acute phase and 1 case of recurrence after allo BMT. There were 7 cases of myelodysplastic syndrome (MDS), 1 case of RAEB and 1 case of RAEB t, 5 cases converted to AL; Burkitt lymphoma Ⅳ in 1 case. The systemic cyclosporine (CsA) plus methotrexate (MTX) regimen was used for the prevention of graft versus host disease (GVHD) with systemic irradiation (TBI) or modified busulfan preconditioning. Results All patients were alive, the median time to recovering neutrophils to ≥0.5 × 10 9 L and BPC ≥ 20 × 10 9 L was 14 and 11 days after transplantation, respectively. There were 20 (39%) cases of acute GVHD Ⅱ degree and above, of which 2 cases (4%) Ⅲ ~ Ⅳ degree. Fifty-two percent of patients diagnosed chronic GVHD. Fourteen died, eight died of transplant-related complications, and six died of recurrence. Thirty-seven patients were long-term survived. The median follow-up time was 399 (75-2 176) days. 34 patients continued CR and 3 patients relapsed. The 2-year overall survival, disease-free survival and relapse rate were 64%, 61% and 24% respectively. Conclusion Allo PBSCT is safe and reliable for the treatment of hematologic malignancies