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目的 观察供体白细胞输注 (DL I)治疗急慢性白血病和多发性骨髓瘤的疗效和安全性。方法 慢性髓性白血病 (CML ) 7例 ,慢性期 (CML - CP) 5例 ,加速期 (CML - AP)和急性变 (CML - BP)各 1例 ,急性髓性白血病 (AML - m2 ) ,急性淋巴细胞白血病 (A L L )和多发性骨髓瘤 (MM)各 2例。预处理方案用去髓性和非去髓性两种。供体白细胞采用 COBE,Spectra血细胞分离机 ,回输的细胞数 (CD3 +)细胞为 (0 .6～ 3.4)× 10 7/ kg,平均细胞数 1.7× 10 7/ kg,DL I前停用免疫抑制剂。非去髓性异基因干细胞移植 (NST)患者通常在移植后每月输注 1次 ,连续 1～ 4次。对移植后或化疗、放疗后复发的患者 ,在复发的早期每月输注 1次 ,也连续 1～ 4次。结果 4例 NST后的 CML- CP患者 DL I2次后嵌合体逐渐形成 ,其中 1例发生全血细胞减少 ,骨髓增生不良 ,经对症治疗后获得CR。 1例异基因骨髓移植后 (allo- BMT)复发的 CML- CP患者在 DL I1次后发生严重再障 ,经抢救后恢复并获CR2 ,长期生存。 1例 CML- AP及 1例 CML- BP患者 NST后虽然联合 DL I2次 ,嵌合体也未出现。 2例 NST后的A ML 患者在 DL I1次后混合嵌合体出现 ,现仍在随访中。 2例 DL I各 1次的 AL L 复发患者 (allo- BMT1例 ) (化疗及交替半身照射后复发 1例 )分别?
Objective To observe the efficacy and safety of donor leukocyte infusion (DL I) in the treatment of acute and chronic leukemia and multiple myeloma. Methods 7 cases of chronic myelogenous leukemia (CML), 5 cases of chronic phase (CML-CP), 1 case of accelerated phase (CML-AP) and one acute change (CML-BP), and acute myeloid leukemia (AML-m2). There were 2 cases of acute lymphoblastic leukemia (ALL) and multiple myeloma (MM). The pretreatment regimen uses both demyelinating and non-demyelinating. The donor leukocytes were COBE, Spectra blood cell separator, the number of returned cells (CD3 +) cells was (0.6 to 3.4) × 10 7 / kg, the average number of cells was 1.7 × 10 7 / kg, which was disabled before DL I. Immunosuppressive agents. Non-myelogenous allogeneic stem cell transplantation (NST) patients are usually infused once a month for 1 to 4 consecutive sessions. For patients who have relapsed after transplantation or who have relapsed after chemotherapy or chemotherapy, they are given monthly infusions 1 to 4 times in the early stages of relapse. Results Four cases of CML-CP patients after NST developed gradually after DL I2 chimera. One patient developed pancytopenia and myelodysplasia. CR was obtained after symptomatic treatment. After one allogeneic bone marrow transplantation (allo-BMT) relapsed CML-CP patients had severe aplastic anemia after DL I1 times, recovered after rescue and received CR2, and had long-term survival. In 1 patient with CML-AP and 1 patient with CML-BP, although chimerism did not occur after NST combined with DL I2. Two patients with AML after NST appeared after DL I1 mixed chimera and are still being followed up. Two cases of AL L recurrence (allo-BMT1) (1 case relapsed after chemotherapy and alternating half-body irradiation) in each case of DL I?