单倍体移植治疗恶性血液病的临床研究

摘要

Objective To study the effect of haploidentical hematopoietic stem cell transplantation as a treatment of hematopoietic malignancies. Methods We used cytosine arabinoside ( Ara-c) , busulphan ( Bu) , cyclophosphamide (CTX) and methyl ccnu (MeCCNU) as preconditioning of patients and then we used cyclophosphamide(CTX), rhG-CSF, cyclosporine A ( CSA ), mycophenolate mofetil ( MMF), the anti-thymocyte globulin ( ATG) , IL-11 and methotrexate( MTX) as prophylaxis of acute graft versus host diseases to treat 8 cases of hematopoietic malignancies. Results All patients achieved complete engraftment. The median times of neutrophil recovery > 1.0 ×109/L were 16. 3 (12～20)days after transplantation. The incidence of grade Ⅲ～Ⅳ aGVHD was 12.5%. All patients survived disease-free with a median follow-up of 28. 8 (4～65) months. Conclusions Haploidentical hematopoietic stem cell transplantation is a safe and effective treatment for hematopoietic malignancies, with Ara-c, Bu, CTX, MeCCNU as preconditioning and CTX, rhG-CSF, CSA, MMF, ATG, IL-11 and MTX as prophylaxis of aGVHD.%目的 探讨单倍体移植治疗恶性血液病的疗效.方法 在单倍体移植时采用阿糖胞苷、马利兰、环磷酰胺、甲基环已亚硝脲联合作为预处理方案,用环磷酰胺、重组人粒细胞集落刺激因子、环孢素、麦考酚酸酯、抗胸腺细胞球蛋白、白细胞介素11及甲氨蝶呤联合预防急性移植物抗宿主病(aGVHD),治疗8例恶性血液病患者.结果 8例患者完全植入,白细胞＞1.0×109/L中位时间为16.3 d(+12～+20 d),Ⅲ～Ⅳ度aGVHD的发生率为12.5%,中位随访时间28.8(4-65)个月,无复发,随访至2010年2月仍存活.结论 在单倍体移植治疗恶性血液病时采用阿糖胞苷、马利兰、环磷酰胺、甲基环己亚硝脲联合作为预处理方案,用环磷酰胺、重组人粒细胞集落刺激因子、环孢素、麦考酚酸酯、抗胸腺细胞球蛋白、白细胞介素11及甲氨蝶呤联合预防aGVHD是一种安全、有效的方法.