摘要
目的 分析马利兰和环磷酰胺 (BU CY)作为异基因外周血干细胞移植 (allo PBSCT)预处理方案的治疗相关并发症。方法 分析 1997年 6月至 1999年 5月我院 40例allo PBSCT患者的临床资料。结果 中性粒细胞和血小板植活中位数时间分别为移植后 13(9～ 2 8)天和 12 (7～ 6 0 )天 ;40例中17例 (42 5 % )发生急性移植物抗宿主病 (aGVHD) ,其中Ⅱ～Ⅳ度aGVHD 10例 (2 5 % ) ;在可评价的 30例中 2 1例 (70 % )发生cGVHD ;发生轻至重度口腔粘膜炎 30例 ,其中 4例发生严重食管炎伴出血 ;发生出血性膀胱炎 8例 (2 0 % ) ,中位数时间为 +10 0 (+7～ +16 5 )天 ;发生间质性肺炎 6例 (2 0 % ) ,其中 5例巨细胞病毒感染 ,1例卡氏肺囊虫感染 ;无一例发生肝静脉闭塞病和癫痫样发作。随访中位数时间 480(30 0～ 10 0 0 )d ,复发 4例 (10 % ) ,死于移植相关并发症 8例 (2 0 % ) ,3年无白血病生存 2 8例 (70 % )。结论 以国产马利兰组成的BU CY预处理方案易于实施 ,患者耐受好 ,髓外毒性低。
Objective To analyse the treatment related complications of busulphan and cyclophosphamide (BU CY) as the conditioning regimen for allogeneic peripheral blood stem cell transplantation (allo PBSCT). Methods The clinical data of 40 leukemia patients undergoing allo PBSCT between June 1997 and May 1999 in our BMT center were retrospectively analysed. Results Recovery of neutrophil and platelet was achieved at a median of day +13 (9～28) and day +12 (7～60) respectively. Acute GVHD occurred in 17 of 40 patients (42 5%) with grade Ⅱ Ⅳ in 10 patients (25%). Chronic GVHD developed in 21 out of 30 evaluable patients (70%). Mild to severe mucositis occurred in 30 patients (75%),and 4 of them had severe esophagitis with bleeding. Haemorrhagic cystitis developed in 8/40 (20%) patients, the median time of its onset was day +100 (+7 to +165). Six of 40 patients (15%) developed interstitial pneumonia (IP), 5 of them were due to cytomegalovirus infection, and the remaining one due to pneumocystis carinii infection. No hepatic veno occlusive disease was observed and no seizure occurred. During the median follow up of 480 (300～1000) days, 4(10%) patients relapsed and 8 (20%) patients died of the transplant related complications. The 3 year leukemia free survival rate was 70%. Conclusion BU(domestic busulfan) CY regimen is relatively easy to administer and well tolerated, with low extramedullary toxicities.
出处
《中华血液学杂志》
CSCD
北大核心
2000年第8期403-405,共3页
Chinese Journal of Hematology
关键词
马利兰
不良反应
造血干细胞移植
异基因
白血病
Busulphan
Cyclophosphamide
Toxicity
Stem cell transplantation
allogeneic
