急性髓性白血病混合造血干细胞移植后DLI+IL-2治疗的临床研究

摘要

目的:探讨急性髓性白血病(acute myeloid leukemia,AML)患者在接受自体外周血干细胞混合人类白细胞抗原(human leukocyte antigen,HLA)半相合异体骨髓移植(Mixed-HSCT)后,继予供体淋巴细胞输注+白介素2(DLI+IL-2)治疗的疗效.方法:对23例AML患者在完全缓解期采用TBI+VEMAC预处理方案,实施Mixed-HSCT.造血恢复后给予DLI+IL-2治疗1-8次.结果:所有患者均获得造血重建,中性粒细胞(ANC)≧0.5×109/L的中位时间为14(12-17)天,白细胞(WBC)≧4.0×108/L的中位时间为17(16-21)天.血小板(PLT)≧20×108/L的中位时间为21(19-23)天,PLT≧50×108/L的中位时间为25(24-27)天.+16至+21天时骨髓检查示恢复期骨髓象,无移植物抗宿主病(graft versus host disease,GVHD)发生,有6例形成混合嵌合体(46XX/46XY).经过3年以上随访,存活15例,长期无病存活率( DFS)为65.2%.结论:Mixed-HSCT后应用DLI+IL-2治疗对急性髓性白血病患者的长期无病生存有积极意义.%Objective: To approach efficacy of treatment with donor lymphocyte infusion combined IL - 2( DLI + IL -2 ) after mixed hematopoietic stem cell transplantation( Mixed - HSCT ) for acute myelogenous leukemia( AML ).Methods: After chemotherapy,23 cases of patients who were diagnosed as AML received Mixed - HSCT and were treated with DLI + IL - 2 for 1 - 8 times after hematopoietic reconstruction.Results: All patients obtained hematopoietic reconstruction.The median times of ANC recove≧ 0.5 × 109/L and WBC recovery ≧ 4.0 × 109/L were 14( 12 - 17 ) and 17( 16 -21 )days,PLT recove≧ 20 × 108/L and 50 × 108/L were 21( 19 -23 ) and 25( 24 -27 )days, there were no any GVHD 6 patients form mixed chimerism( 46XX/46XY ).Disease - free survival ( DFS ) was 65.2％ ,with a follow - up over 3 years.Conclusion: Treatment with DLI + IL -2 after mixed - HSCT for acute myelogenous leukemia may increase DFS efficiently.