论文部分内容阅读
目的 探讨NST治疗恶性血液病的效果及毒性。方法 急性粒细胞白血病未分化型 (AML -M1)、慢性髓细胞白血病 (CML)、骨髓增生异常综合征 (MDS -RA)患者各 1例 ,供体为其HLA配型完全相合的同胞。供体动员方案 :G -CSF 30 0 μg/ 12h× 5d后分离采集外周血干细胞。所获CD34 + 细胞数分别为 6 .36× 10 6/kg、9.72×10 6/kg、6 .6 2× 10 6/kg ;单个核细胞数 (MNC)分别为 14.0× 10 8/kg、10 .47× 10 8/kg、8.5 8× 10 8/kg ;T细胞总数分别为 8.80× 10 8/kg、7.12× 10 8/kg、5 .6 7× 10 8/kg ;CFU -GM数分别为 16 2个 / 2× 10 5MNC、184个 / 2× 10 5MNC、182个 / 2× 10 5MNC。预处理方案 :Fludarabine:30mg/m2 ·d-1× 6d ,Bu :4mg/kg·d-1× 2d ,ALG :12mg/kg·d-1× 4d ,Ara-C :10 0mg/m2 ·d-1× 3d。单用环胞菌素 (CSA)预防移植物抗宿主病 (GVHD)。移植后未用造血生长因子。结果 患者均能顺利完成预处理方案 ,没有严重并发症出现。移植后 10～ 13d造血重建。未发生急性GVHD。随访10 0～ 16 0d ,血常规、骨髓象均正常 ,1例发生肝脏型慢性GVHD。结论 NST能有效治疗恶性血液病 ,方案相关毒性小 ,适用范围广 ,移植相关并发症少 ,造血重建迅速。
Objective To investigate the efficacy and toxicity of NST in the treatment of hematologic malignancies. Methods One patient with acute myeloid leukemia undifferentiated (AML-M1), chronic myelogenous leukemia (CML) and myelodysplastic syndrome (MDS-RA) was selected. The donor was a matched sibling with HLA matching. Donor mobilization program: G-CSF 30 ug / 12h × 5d after the separation and collection of peripheral blood stem cells. The number of CD34 + cells obtained was 6 .36 × 10 6 / kg, 9.72 × 10 6 / kg and 6. 6 × 10 6 / kg respectively. The number of mononuclear cells (MNC) was 14.0 × 10 8 / kg, 10.47 × 10 8 / kg and 8.5 8 × 10 8 / kg, respectively; the total number of T cells were 8.80 × 10 8 / kg, 7.12 × 10 8 / kg and 5.66 × 10 8 / kg, 16 2/2 × 10 5 MNC, 184/2 × 10 5 MNC and 182/2 × 10 5 MNC, respectively. Pretreatment: Fludarabine: 30mg / m2 · d-1 × 6d, Bu: 4mg / kg · d-1 × 2d, ALG: 12mg / kg · d-1 × 4d, Ara-C: 100mg / m2 · d -1 × 3d. Cyclosporine alone (CSA) prevents graft versus host disease (GVHD). No hematopoietic growth factor after transplantation. Results All patients successfully completed the pretreatment program without any serious complications. 10 ~ 13d after transplantation hematopoietic reconstruction. No acute GVHD occurred. All the patients were followed up for 10 0 ~ 16 0 days. The blood and bone marrow were all normal. One case had liver chronic GVHD. Conclusion NST can effectively treat hematologic malignancies. It is less toxic and has a wide range of application, less complications related to transplantation and rapid hematopoietic reconstitution.