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对1例慢性粒细胞性白血病患者在全身用射7.0Gy、环磷酰胺80mg/kg和柔红霉素80mg预处理后行异基因骨髓移植,供体骨髓细胞未能植入成功,经综合治疗,患者恢复了自身造血功能。移植后14个月骨髓Ph1染色体重现,24个月达临床复发,随访至术后44个月,骨髓象检查仍处慢性期。术后46个月,经马利兰、羟基脲和环磷酰胺联合化疗预处理,患者接受了同一供体的第2次骨髓移植,获得成功。患者骨髓Ph1染色体持续阴性。结果表明,异基因骨髓移植能持久地消除Ph1阳性克隆细胞,从而可能治愈本病,而大剂量放疗及化疗则不能持久根除Ph1阳性细胞,但Ph1染色体转阴时间比强烈联合化疗或干扰素治疗明显延长。
Allogeneic bone marrow transplantation was performed on one patient with chronic myeloid leukemia after whole body irradiation with 7.0Gy, cyclophosphamide 80mg / kg and daunorubicin 80mg. The donor bone marrow cells could not be implanted successfully. Treatment, the patient has restored its own hematopoietic function. Fourteen months after transplantation, the bone marrow Ph1 chromosome recurrence, 24 months of clinical recurrence, follow-up to 44 months after surgery, bone marrow examination is still chronic. At 46 months postoperatively, the patient underwent the second bone marrow transplant from the same donor who was successfully treated with a combination of Maryland, hydroxyurea and cyclophosphamide. Patient bone marrow Ph1 chromosomes were persistent. The results showed that allogeneic bone marrow transplantation can permanently eliminate Ph1 positive clonal cells, which may cure the disease, while high-dose radiotherapy and chemotherapy can not be eradicated Ph1-positive cells, but the Ph1 chromosome than the strong combination chemotherapy or interferon therapy Significantly longer.