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为了评价供者应用G-CSF的骨髓移植治疗慢性粒细胞白血病的临床疗效,用HLA相合的、混合淋巴细胞培养阴性的同胞供者骨髓,对单一病种慢性粒细胞白血病行移植治疗。供者应用G-CSF 250微克/天,连用7天后供髓的32例为研究组,对照组18例常规采髓移植,在预处理方案,GVHD预防和支持治疗方法相同的情况下,比较研究组和对照组移植后在加速造血重建,降低GVHD发生和延长无病生存的疗效。移植结果显示,供者应用G-CSF在慢性粒细胞白血病移植中造血重建加速,中性粒细胞>0.5×10~9/L和血小板>20×10~9/L的中位天数分别是第15(10-22)天和第17.5(13-28)天,对照组是第21和24天(P<0.01),研究组发生急性Ⅱ-Ⅳ度GVHD 2例(6.3％),对照组5例(27.8％),通过比较,两组差异有显著性(P<0.05),慢性GVHD发生分别是24％和33.3％(P>0.05)。研究组移植相关死亡、复发和无病生存与对照组比较无统计学差异(P>0.05)。结论:使用G-CSF动员供者的HLA相合的异基因骨髓移植,造血重建加快和重度急性Ⅱ-Ⅳ度GVHD减轻,有可能提高CML移植的无病生存率。
To evaluate the clinical efficacy of donor bone marrow transplantation with G-CSF in the treatment of chronic myeloid leukemia, HLA-matched, mixed lymphocyte-negative fellow bone marrow donors were used to treat single disease chronic myeloid leukemia. Donor application of G-CSF 250 micrograms / day, for 7 days after the application of the pulp in 32 cases of study group, control group of 18 cases of conventional levator transplantation, pretreatment programs, GVHD prophylaxis and supportive treatment of the same circumstances, the comparative study Group and control group in accelerating hematopoietic reconstitution after transplantation, reducing the incidence of GVHD and prolong the efficacy of disease-free survival. Transplantation results showed that donor G-CSF accelerated the hematopoietic reconstitution in chronic myeloid leukemia transplantation. The median days for neutrophils> 0.5 × 10 ~ 9 / L and platelets> 20 × 10 ~ 9 / L were The control group was on days 21 and 24 (P <0.01) at 15 (10-22) days and on days 17.5 (13-28). Two cases (6.3%) of acute grade Ⅱ- Cases (27.8%), by comparison, there was significant difference between the two groups (P <0.05), chronic GVHD were 24% and 33.3% (P> 0.05). There was no significant difference in the mortality, relapse and disease-free survival between study group and control group (P> 0.05). CONCLUSIONS: HLA-matched allogeneic bone marrow transplantation using G-CSF-mobilized donors, accelerated hematopoietic reconstitution, and reduced severity of acute grade II-IV GVHD may improve the disease-free survival of CML patients.