摘要
目的：探讨格列卫联合非清髓性单倍体造血干细胞移植在治疗慢性粒细胞白血病（CML）中的作用。方法：4例CML患者，采用移植前、后口服格列卫，以环磷酰胺、阿糖胞苷、抗胸腺细胞球蛋白、赛尼派、环胞素A等作非清髓性预处理的单倍体异基因外周血造血干细胞移植。结果：移植过程顺利，4例患者均植入成功，嵌合性植入。中性粒细胞〉0．5×10^9／L。天数，16（10～21）d；血小板〉20×10^9／L天数，10（4～15）d。3例发生I～Ⅱ度皮肤急性移植物抗宿主病（GVHD），1例发生Ⅳ度皮肤慢性GVHD。1例＋27d死于肺部感染并多脏器功能衰竭，1例死于Ⅳ度皮肤慢性GVHD并发感染。2例无病存活（随访16个月仍健在），且Ph^＋染色体，bcr-abl融合基因转阴。结论：非清髓单倍体造血干细胞移植联合格列卫治疗CML，具有降低移植前白血病细胞负荷，抑制残留白血病细胞增殖，促进供者完全嵌合状态的转变，增强抗移植物白血病（GVL）效应的作用，是一种有效的治疗方法，值得进一步临床研究。
Objective：To study effect of the treatment of Glivec combined with transplantation of haploidentical nonmyeloablative allogeneic peripherial blood stem cells （NST） for chronic myelogenous leukemia. Method： 4 patients of CML received haploidentical nonmyeloablative allogeneic peripherial blood stern cells transplantation combined with Glivec. They all took glivec before and after transplantation. Using CTX, Ara-C, Fludarabine, ATG, Zenapax, CSA as the conditioning regimen for transplantation of haploidentical nonmyeloablative allogeneic peripherial blood stem cells. Result：All the 4 patients had engraftments of mixed chimerism donor cells. The time of neutraphils greater than 0.5× 10^9/L was 16 days （Range 10～ 21 days）. The time of platelets greater than 20× 10^9/ L was 10 days （Range 4～15 days）. 4 cases had Ⅰ～Ⅱ degree of acute GVHD of skin. 1 case had Ⅳ degree of chronic GVHD of skin. 1 case died of lung infection and multi orgen failure. 1 case died of Ⅳ degree of chronic GVHD of skin and infection. 2 cases survived for 16 months with negative Ph＋ chromsome and bcr/abl gene. Conclusion：The treatment of haploidentical NST combined with Glivec before and after the transplantation for CML could reduced leukemic cell load, inhibited the proliferation of residual leukemic cells, promoted full chimerism change and enhanced the effect of GVL. It provided an effective method for CML.
出处
《临床血液学杂志》
CAS
2006年第1期3-6,共4页
Journal of Clinical Hematology
关键词
造血干细胞移植
白血病
粒细胞性
慢性
非清除性预处理
Hematopoitic cell transplantation
Chronic myleogenous leukemia
Nonmyleoablative precondi-tioning
