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目的分析总结慢性粒细胞白血病患者异基因外周血干细胞移植过程。方法预处理采用BuCy方案(马利兰4mg.kg-1.d-1×4d,环磷酰胺60mg.kg-1.d-1×2d)。移植物抗宿主病(GVHD)预防采用环胞素A(CsA)联合氨甲碟呤(MTX)、骁悉(MMF)。结果+16d造血重建。+24d开始出现GVHD,首先表现为眼部疾患,其后累及皮肤、胃肠道、肝脏、膀胱及骨髓等器官。+34d外周血DNA基因型转变为供者型;+74d血型完全转变为供者型。结论GVHD临床表现多样,以眼部疾患为首发表现较少见。早期识别和正确处理GVHD是提高移植成功率的关键。
Objective To analyze and summarize the allogeneic peripheral blood stem cell transplantation in patients with chronic myeloid leukemia. Methods Pretreatment BuCy regimen (4mg.kg-1.d-1 × 4d Maryland, 60mg.kg-1.d-1 × 2d cyclophosphamide). Prevention of graft-versus-host disease (GVHD) with cyclosporin A (CsA) combined with methotrexate (MTX), MMF. Results + 16d hematopoietic reconstitution. The onset of GVHD on +24 d first manifests as eye disorders followed by the skin, gastrointestinal tract, liver, bladder and bone marrow. + 34d DNA genotype of peripheral blood donor type; + 74d blood type completely converted to donor type. Conclusions The clinical manifestations of GVHD are diverse, and the first manifestation of eye disease is rare. Early identification and correct treatment of GVHD is the key to increasing the success rate of transplantation.