摘要
目的 探讨异基因外周血干细胞移植治疗急变期慢性髓性白血病的疗效 ;观察其造血、免疫重建过程、移植物抗宿主病 (GVHD)及其它移植并发症发生情况 ;并长期随访。方法 给 1例急变期慢性髓性白血病患者移植其 6 5岁母亲的HLA A ,B ,DR位点相合的外周血干细胞。预处理用CTX/TBI方案 (环磷酰胺 6 0mg·kg-1·d-1× 2d ,全身照射总剂量为 8.0 0Gy ,剂量率9.38cGy)。以氨甲喋呤 (MTX)及环孢素A(CsA)预防GVHD。移植有核细胞数为 3.185× 10 8/kg ,CD34 + 细胞数2 .0 3× 10 6/kg。 结果 移植后第 3w(+2 1d)始骨髓显示造血重建 ;+2 3d中性粒细胞 (ANC) >1.0× 10 9/L ;+36d性染色体检测显示移植物植入成功 ;随访 430d ,未发生明显的急、慢性GVHD ,患者处于血液学、分子遗传学缓解状态 ,成功的重建造血和免疫功能 ,并已回到工作岗位。结论 本例为国内首例异基因外周血干细胞移植治疗急变期慢性髓性白血病获得成功 ;
ObjectivesTo investigate the therapeutic effects of allogeneic peripheral blood stem cell transplantation (PBSCT) in the treatment of chronic myelogenous leukemia in blast phase, and observe the persistent hematopoietic and immunological reconstitution, graft versus host disease (GVHD) and transplantation related complications. Methods A 35 year old male with chronic myelogenous leukemia in monocytic blast crisissuccessfully received a PBSCT. The donor was his 65 year old mother who was identical with the patient at the HLA A,B and HLA DRB1,DRB3/B4 loci. The conditioning regimens included CTX (60?mg/kg every day for 2 days) and TBI ( 8.00?Gy). GVHD prophylaxis was CsA and short course of MTX. The infused nucleated cells dose was 3.185×10 8/kg, including 2.03×10 6/kg CD34 + cells. Results The patient showed rapid hemopoietic reconstitution at the 3?rd week after transplantation, ANC> 1.0×10 9/L at +23 day, and successful engraftment was conformed at +36 day. The patients did not developed acute or chronic GVHD and was currently 430 days post transplant with hematological and cytogenetic complete remission and had a normal daily social life. Conclusions It is the first case reported in China that allogeneic PBSCT was successfully applied in the treatment of chronic myelogenous leukemia in blast phase.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2001年第6期339-341,共3页
Chinese Journal of Organ Transplantation
