地西他滨加改良CAG方案联合人白细胞抗原半相合淋巴细胞输注治疗老年急性髓系白血病缓解1例

摘要

Myelodysplastic syndrome (MDS) is a group of malignant clone diseases owing to hematopoietic stem cell abnormality, which can transform to acute myeloblastic leukemia (AML). After MDS transforms to AML, the leukemia cells usually can not be effectively killed or inhibited, and bone marrow suppression becomes fairly severe. After chemotherapy, hemorrhage and infection in the period of bone marrow suppression are usually the main reasons for mortality. Therefore, the AML patients secondary to MDS usually have poor prognosis and are difficult to treat. Recently, we utilized decitabine and regimen of cytarabine, aclacinomycin and granulocyte-colony stimulating factor (CAG) combined with haploidentical lymphocyte infusion to treat a 62-year-old male with MDS-transformed AML. The symptoms were successfully remitted, with markedly shortened bone marrow suppression and favorable outcome.%骨髓增生异常综合征（MDS）是一组造血干细胞异常的恶性克隆性疾病，可转化为急性髓系白血病（AML）。MDS转化为AML时，化疗常常不能有效杀灭或抑制肿瘤细胞，且骨髓抑制相当严重，化疗后骨髓抑制期的出血、感染常成为患者临床死亡主要原因。因此，继发于MDS的AML患者预后差，治疗困难。近期笔者应用地西他滨加阿糖胞苷、阿克拉霉素和粒细胞集落刺激因子（CAG）联合半相合淋巴细胞回输，成功诱导缓解1例继发于MDS的AML，并显著缩短化疗后的骨髓抑制期，获得良好疗效。