摘要
目的探讨HLA单体型相合造血干细胞移植（HSCT）治疗白血病的疗效。方法对2005年1月-2009年6月我院的107名白血病患者进行HLA单体型相合造血干细胞移植。采用大剂量的预处理、联合免疫抑制、体内去除T细胞;G-CSF动员的外周血加骨髓干细胞混合移植方案。结果所有患者均植活供者干细胞,造血重建。54名患者（50.5%）发生aGVHD,其中Ⅰ级33例,Ⅱ级11例,Ⅲ级7例,Ⅳ级3例;Ⅲ-Ⅳ级占18.5%。38名患者（35.5%）发生cGVHD,有4例为广泛性cGVHD。造血重建后完全缓解率（CR）为94.4%,68例患者存活,1年总生存率（OS）为70.4%,无病生存率（DFS）为68.2%,复发率为21.8%,移植相关死亡率为15.9%。结论预处理方案、GVHD预防措施及移植物成分的优化改良,使HLA单倍相合造血干细胞移植的疗效明显改善。
Objective To explore the effect of HLA-haploidentical hematopoietic stem cell transplantation in treatment of leukemia.Methods From January 2005 to June 2009,one hundred and seven patients with leukemia in our hospital received HLA-haploidentical hematopoietic stem cell transplantation.All patients were treated with large dose preconditioning,intensive immunosupp ression,removaling T cells in vivo,granulocyte colony stimulating factor（G-CSF）mobilization and combination of bone marrow and peripheral blood stem cell transplantation.Results All patients achieved sustained,full donor-type engraftment.Fifty-four patients（50.5%）occurred aGVHD.Thirty-three of them were gradeⅠaGVHD,eleven grade Ⅱ aGVHD,seven grade Ⅲ aGVHD and three grade ⅣaGVHD.The cumulative incidence of grade Ⅲ～Ⅳ aGVHD was 18.5%,cGVHD was observed in 38 of 107 patients and four of them were extensive cGVHD.After hematopoiesis reconstruction,the CR rate was 94.4%.Sixty-eight patients were alive with 70.4% one year overall survival rate and 68.2% one year disease-free survival rate.Relapse rate was 21.8% and transplantation related mortality was 15.9%.Conclusion HLA-haploidentical HSCT is a relatively efficient method for the treatment of patients with leukemia who have no related matched donors.
出处
《中国输血杂志》
CAS
CSCD
北大核心
2011年第1期8-12,共5页
Chinese Journal of Blood Transfusion
关键词
单体型相合
造血干细胞移植
白血病
移植物抗宿主病
Haploidentical
Hematopoietic stem cell transplantation
Leukemia
Graft versus host diease
