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目的探讨HLA半相合非清髓异基因造血干细胞移植(NAST)在治疗难治性急性白血病中的作用。方法2002-06采用非清髓预处理的NAST治疗军事医学科学院附属307医院难治性急性髓性白血病患者1例。预处理方案主要由抗淋巴细胞球蛋白(ATG)、阿糖胞苷(Ara-C)、氟达拉滨(Flu)和环磷酰胺(CTX)等组成。移植物抗宿主病(GVHD)的预防采用环孢素A(CSA)、霉酚双酯(MMF)、甲氨蝶呤(MTX)和CD25单抗。结果患者移植过程顺利,于移植后第100d转为完全供者型植入。患者于移植后出现皮肤Ⅰ度GVHD,经治疗后好转。结论应用HLA半相合NAST治疗难治性急性白血病患者,简便安全,疗效好,为无HLA相合供者的白血病患者治疗开辟了新的治疗手段。
Objective To investigate the role of HLA haploidentical non-myeloablative allogeneic hematopoietic stem cell transplantation (NAST) in the treatment of refractory acute leukemia. Methods A non-myeloablative preconditioning NAST was performed in one of 307 patients with refractory acute myeloid leukemia affiliated to the Academy of Military Medical Sciences. The pretreatment regimen mainly consists of anti-lymphocyte globulin (ATG), Ara-C, Flu and cyclophosphamide (CTX). Prevention of graft-versus-host disease (GVHD) uses cyclosporine A (CSA), mycophenolate mifepride (MMF), methotrexate (MTX) and CD25 mAb. Results The patient was successfully transplanted and was transplanted to full donor type on the 100th day after transplantation. Patients with skin grade Ⅰ GVHD after transplantation, after treatment improved. Conclusions The application of HLA haploidentical NAST in the treatment of patients with refractory acute leukemia is simple, safe and effective and has opened up a new therapeutic approach for the treatment of leukemia patients without HLA-matched donors.