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目的:观察混合BMT治疗恶性血液病的临床疗效,方法:用自体骨髓混合HLA半相合异基因骨髓移植,同时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,以提高体内对残留肿瘤细胞的净化效应,减弱GVHD反应和增强GVL效应,结果:①MBMT是安全的,16例中无1例发生急性GVHD,②近期疗效较好,移植后16例中5例复发,11例未复发,其中7例中位随访12月仍存活且CCR,余4例死于并发症和其它非血液病;③16例除1例因早期死于VOD外,余皆成功造血重建;④对6例供受者性别不同患者性染色体分析发现3例移植后形成嵌合体,最长者已15月余.结论:本研究为临床恶性血液病治疗可能提供了一个新的途径.
OBJECTIVE: To observe the clinical efficacy of mixed BMT in the treatment of hematological malignancies by using autologous bone marrow mixed with HLA haploidentical allogeneic bone marrow transplantation, and in vitro hyperthermia and liquid culture combined with IL-2 to activate bone marrow cells and injecting IL-2 after transplantation. To improve the body’s purifying effect on residual tumor cells, weaken the GVHD reaction and enhance the GVL effect. Result: 1MBMT is safe, 16 cases have no acute GVHD, 2 has good curative effect in the near future, 5 cases relapse after 16 cases Of the 11 patients who did not experience recurrence, 7 patients were still followed by CCR at median follow-up of 12 months. The remaining 4 patients died of complications and other non-hematologic diseases. Among 316 patients except one who died of VOD early, all of them successfully reconstructed hematopoietic reconstitution. Sex chromosome analysis of 4 sex pairs of 6 donors showed that 3 cases had chimeras after transplantation, and the longest had been more than 15 months. Conclusion: This study may provide a new approach for the treatment of clinical hematological malignancies.