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目的 评价非亲缘异基因骨髓移植 (allo BMT)治疗恶性血液病的疗效及并发症。方法 予 13例恶性血液病患者非亲缘allo BMT ,预处理方案髓系白血病为改良BUCY ;急性淋巴细胞白血病 (ALL)和合并中枢神经系统白血病 (CNS L)的髓系白血病以全身照射 (TBI) +环磷酰胺 (CTX)为主的化疗。 13例均采用骁悉 (MMF)、CSA加短程MTX联合方案预防移植物抗宿主病 (GVHD)。结果 均较顺利完全预处理及移植治疗。移植后 17d(中位时间 )造血重建。GVHD发生率急性Ⅰ～Ⅲ度 38% ,Ⅲ～Ⅳ度 15 %。随访 2～ 30个月 ,荧光标记STR PCR定量检测 ,75 %患者供体细胞嵌合率(DM) >90 %。 12例非复发状况移植 ,至今存活 9例 ,无白血病生存率 (LFS) 75 %。移植相关死亡率30 %。结论 非亲缘allo BMT能有效地治疗或根治恶性血液病。
Objective To evaluate the efficacy and complications of allogeneic bone marrow transplantation (allo BMT) in the treatment of hematologic malignancies. Methods Thirteen patients with unrelated allogeneic hematologic malignancy (BMT) and myeloid leukemia (ALL) and myeloid leukemia with central nervous system leukemia (CNS L) were treated with systemic irradiation (TBI) + Cyclophosphamide (CTX) based chemotherapy. Thirteen patients were treated with MMF and CSA combined with short-course MTX to prevent graft-versus-host disease (GVHD). The results were more successful and complete pretreatment and transplantation. 17d after transplantation (median time) hematopoietic reconstitution. The incidence of GVHD acute Ⅰ ~ Ⅲ degree 38%, Ⅲ ~ Ⅳ degree 15%. The patients were followed up for 2 to 30 months. The fluorescence quantitative PCR assay was used to detect the rate of donor chimerism (DM)> 90% in 75% of patients. Twelve non-recurrent cases were transplanted and 9 survived to date with no leukemia survival (LFS) of 75%. Transplant-related mortality was 30%. Conclusion Noninvasive allo BMT can effectively treat or cure hematologic malignancies.