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背景:HLA相合同胞间异基因外周血造血干细胞移植是治疗急性白血病的一种有效方法。目的:评价HLA相合异基因外周血造血干细胞移植治疗急性白血病的临床疗效及并发症。方法:25例急性白血病患者接受HLA相合同胞的异基因外周血造血干细胞移植,其中急性髓系白血病20例,急性淋巴细胞白血病5例。预处理方案为BU+CY方案或CY+TBI方案,移植物抗宿主病预防采用环孢素A+吗替麦考酚酯+短程甲氨蝶呤。结果:最短随访2个月,最长随访80个月。患者均获造血重建,中性粒细胞≥0.5×109L-1的时间为10～18d,血小板≥20×109L-1的时间为10～37d。主要并发症:感染败血症12例,巨细胞病毒感染9例,带状疱疹病毒感染3例,发生急性移植物抗宿主病10例,慢性移植物抗宿主病11例,出血性膀胱炎4例。至随访结束,17例无病生存,8例死亡。提示HLA相合同胞异基因外周血造血干细胞移植是治疗急性白血病安全有效的方法。
BACKGROUND: HLA-identical sibling allogeneic peripheral blood stem cell transplantation is an effective method for the treatment of acute leukemia. Objective: To evaluate the clinical efficacy and complications of HLA-matched allogeneic peripheral blood stem cell transplantation in the treatment of acute leukemia. Methods: Twenty-five patients with acute leukemia underwent HLA-identical sibling allogeneic peripheral blood stem cell transplantation, including 20 acute myeloid leukemia patients and 5 acute lymphoblastic leukemia patients. Pretreatment program BU + CY program or CY + TBI program, prevention of graft-versus-host disease using cyclosporine A + mycophenolate mofetil + short-range methotrexate. Results: The shortest follow-up of 2 months, the longest follow-up of 80 months. Patients were hematopoietic reconstructed, neutrophil ≥ 0.5 × 109L-1 for 10 ~ 18d, platelet ≥ 20 × 109L-1 for 10 ~ 37d. The main complication was infection sepsis in 12 cases, cytomegalovirus infection in 9 cases, herpes zoster virus infection in 3 cases, acute graft versus host disease in 10 cases, chronic graft versus host disease in 11 cases and hemorrhagic cystitis in 4 cases. By the end of follow-up, 17 had disease-free survival and 8 had died. Suggest that HLA-matched sibling allogeneic peripheral blood stem cell transplantation is a safe and effective method for the treatment of acute leukemia.