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目的:观察非清髓异基因外周造血干细胞移植(NAST)对难治性恶性血液病的疗效。方法:采用NAST治疗 3例慢性粒细胞白血病加速期(CML -AP)、1例骨髓增生异常综合征(MDS-RAEB T)患者。非清髓预处理方案:氟达拉宾 (Flud)30mg·m-2·d-1×6d,白消安(Bu)4mg·kg-1·d-1×2d,环磷酰胺(CTX)600mg·d-1×2d,3例CML- AP患者在此基 础上加用阿糖胞苷(Ara c)。结果:4例患者造血均顺利恢复,ANC>0.5×109/L平均为12天,BPC>20×109/L平均为11天。 +30天时经短串联重复序列(STR)- PCR检测3例患者为完全嵌合体(CC),1例慢粒患者为混合嵌合体(MC),+90天时全部 患者均处于CC。分别随访4月～16月,均无病存活。结论:非清髓异基因外周造血干细胞移植是治疗CML- AP、MDS -RAEB T 等难治性恶性血液病的有效手段。
Objective: To observe the effect of non-myeloablative allogeneic peripheral blood stem cell transplantation (NAST) on refractory hematologic malignancies. Methods: Three patients with accelerated chronic myeloid leukemia (CML-AP) and one with myelodysplastic syndrome (MDS-RAEB T) were treated with NAST. Non-myeloablative preconditioning regimen: Flud 30mg · m-2 · d-1 × 6d, Busp 4mg · kg-1 · d-1 × 2d, Cyclophosphamide (CTX) 600mg · d-1 × 2d, 3 cases of CML-AP patients on this basis with the addition of cytarabine (Ara c). Results: Hematopoiesis recovered smoothly in all 4 patients. The mean ANC> 0.5 × 109 / L was 12 days and the average BPC> 20 × 109 / L was 11 days. Three patients were completely chimerism (CC) detected by short tandem repeat (STR) -PCR at day 30 and mixed chimera (MC) in one chronic patient. All patients were in CC at +90 days. Were followed up for 4 months to 16 months, were disease-free survival. Conclusion: Non-myeloablative allogeneic peripheral blood stem cell transplantation is an effective method to treat refractory malignant hematological diseases such as CML-AP and MDS-RAEB T.