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G-CSF动员的供者淋巴细胞输注治疗异基因造血干细胞移植后慢性髓细胞白血病复发 被引量：1

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摘要 目的探索G-CSF动员的供者淋巴细胞输注治疗异基因造血干细胞移植(allo-HSCT)后白血病复发的方法。方法慢性髓细胞白血病慢性期(CML-CP)患者1例,白消安/环磷酰胺(Bu/Cy)方案预处理,供受者为同胞间HLA6/6相合,回输外周血干细胞,单个核细胞8.69×108/kg,CD34+细胞6.69×106/kg。急性移植物抗宿主病(GVHD)的预防采用骁悉(MMF)、环胞素A(CsA)联合短疗程甲氨蝶呤(MTX)方案。移植后125天,分子生物学复发。先后给予3次未经动员的供者淋巴细胞输注(DLI),细胞剂量分别为1×107/kg、1.5×107/kg和1.5×107/kg。移植后307天,给予G-CSF动员的DLI,MNC 8.69×108/kg。结果 ANC≥0.5×109/L的时间是移植后16天,PLT≥20×109/L的时间是移植后19天。移植后41天,FISH结果示Bcr/Abl融合基因阴性,XX染色体占59%,移植后125天分子生物学复发。3次DLI后患者Bcr/Abl融合基因逐渐下降,XX染色体的比例逐渐上升,但出现严重的全血细胞减少。在G-CSF动员的DLI联合CsA治疗后,患者造血恢复,完全供者型植入,没有出现GVHD的临床表现,并且达到了分子生物学完全缓解。结论 G-CSF动员的DLI和传统的较未经G-CSF刺激的DLI安全性高,且有较好的GVL效应。
作者 高力 张诚 张曦 高蕾 刘嘉
机构地区 全军白血病中心.第三军医大学附属新桥医院血液科.重庆市医学重点学科
出处 《西部医学》 2012年第11期2072-2074,共3页 Medical Journal of West China
基金 重庆市医学重点学科(编号:2006C028) 第三军医大学新桥医院"1130"人才工程培养基金资助(编号:2012)
关键词 供者淋巴细胞输注 造血干细胞移植 白血病 复发
分类号 R733.72 [医药卫生—肿瘤]
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参考文献10

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二级参考文献9

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西部医学
2012年 第11期

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