目的：探讨粒细胞集落刺激因子（ G－CSF）诱导移植物抗白血病效应治疗异基因造血干细胞移植后复发白血病的临床有效性和安全性。方法选取2011年7月至2013年2月在北京军区总医院血液科行异基因造血干细胞移植后复发的白血病患者40例，其中急性淋巴细胞白血病二次缓解10例、急性髓系白血病二次缓解16例、急性髓系白血病三次缓解4例、混合细胞白血病6例，加速期慢性髓系白血病4例，予G－CSF动员后，供者外周血单个核细胞输注，每次输注细胞量逐级增加，每次输注间隔4周。观察供者输注外周血单个核细胞的疗效，并随访并发症情况。结果再次完全缓解24例，未缓解16例。输注后，发生Ⅰ～Ⅱ度急性移植物抗宿主病6例，慢性移植物抗宿主病29例，未发生并发症5例。结论 G－CSF 诱导移植物抗白血病效应治疗对白血病复发有较好的疗效，不良反应小。%Objective To explore the clinical efficacy and safety of granulocyte colony stimulating factor ( G-CSF)-induced graft-versus-leukemia effect in the treatment of leukemia relapse after allogeneic hemato-poietic stem cell transplantation.Methods A total of 40 cases of relapse leukemia after allogeneic hemato-poietic stem cell transplantation from Department of Hematology,General Hospital of Beijing Military Com-mand between Jul.2011 and Feb.2013 were included in the study,including 10 cases of acute lymphoblastic leukemia-CR2,16 cases of acute myeloid leukemia-CR2,4 cases of acute myeloid leukemia-CR3,6 cases of acute mixed lineage leukemia and 4 cases of chronic myeloid leukemia at accelerated phase.After G-CSF mobilization,donor peripheral blood mononuclear cells were infused.The infusion cell volume increased step by step at each infusion with an interval of 4 weeks.The efficacy,complications of the infusion and follow-up was done.Results There were 24 cases of second complete remission,16 cases without remission.After the infusion,Ⅰ-Ⅱ acute graft-versus-host disease was seen in 6 patients,chronic graft-versus-host disease was seen in 24 patients,and complications occurred in 5 patients.Conclusion G-CSF-induced graft-versus-leu-kemia has good effect for the treatment of relapse of leukemia,with less adverse reactions.
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