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目的评价FIBA(Flu、IDA FIBABu、Ara-C)方案预处理对异基因外周血干细胞移植(Allo-PBSCT)治疗急性髓细胞白血病(AML)的疗效影响。方法用Allo-PBSCT治疗AML患者48名。预处理方案为不含TBI的低剂量FIBA,采用环孢菌素+霉酚酸酯+甲氨蝶呤常规预防性控制移植物抗宿主病,非亲缘关系移植加用兔抗人免疫球蛋白。结果 48名患者移植后造血功能均重建,急性移植物抗宿主病发生率22.9%,慢性移植物抗宿主病发生率33.3%,其中局限型占25.4%;11名患者于移植后1~16个月分别有3名(6.25%)死于移植物抗宿主病、3名(6.25%)死于感染和5名(10.4%)死于疾病复发或进展,37名患者已无病存活3~36个月。结论 FIBA方案预处理在急性髓细胞白血病异基因外周血干细胞移植中安全可行,具有疗效可靠,植入安全,副作用小,可调控GVHD并用于预防中枢神经系统白血病等优点。
Objective To evaluate the effect of FIBA (Flu, IDA FIBABu, Ara-C) pretreatment on allogeneic peripheral blood stem cell transplantation (Allo-PBSCT) in the treatment of acute myeloid leukemia (AML). Methods Allo-PBSCT treatment of 48 patients with AML. Pretreatment regimen was low dose TBI-free FIBA. Cyclosporine + mycophenolate and methotrexate were routinely used to prevent graft-versus-host disease. Non-related grafts were supplemented with rabbit anti-human immunoglobulin. Results The hematopoietic function was reconstructed in 48 patients after transplantation. The incidence of acute graft-versus-host disease was 22.9% and the incidence of chronic graft-versus-host disease was 33.3%, of which 25.4% was localized. Among 11 patients, 1 to 16 Three (6.25%) died of graft-versus-host disease, 3 (6.25%) died of infection, and 5 (10.4%) died of disease recurrence or progression in a month, and 37 patients survived disease-free 3-36 Months. Conclusion Pretreatment with FIBA is safe and feasible in allogeneic peripheral blood stem cell transplantation of acute myeloid leukemia. It has the advantages of reliable curative effect, safe implantation, small side effects, control of GVHD and prevention of central nervous system leukemia.