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目的 探讨异基因外周造血干细胞移植预处理相关并发症及其治疗。 方法 研究 30例异基因外周造血干细胞移植患者的临床资料 ,预处理方案包括马利兰、环磷酰胺和阿糖胞苷。 结果 中性粒细胞和血小板植活的中位时间分别为 +14d(10～ 19d)和 +13d(9～ 2 4d) ;30例中 4例 (13 3% )发生急性移植物抗宿主病(aGVHD) ,均为Ⅰ～Ⅱ度 ;9例 (30 % )出现慢性移植物抗宿主病 (cGVHD) ;5例发生出血性膀胱炎 (占 16 7% ) ,3例出现间质性肺炎 (10 % ) ;发生口腔黏膜炎 13例 (4 3 3% ) ;无 1例发生肝静脉闭塞综合征和癫样抽搐。随访中位时间 36 6d(170～ 16 0 0d) ,复发 3例 (10 0 % )。死于移植相关并发症 1例 (3 3% )。 结论 以马利兰、环磷酰胺、阿糖胞苷组成的BCA预处理方案毒性低 ,相关并发症少 ,安全有效 ,易于实施。
Objective To investigate the complications and treatment of pre-treatment of allogeneic peripheral blood stem cell transplantation. Methods The clinical data of 30 patients with allogeneic peripheral blood stem cell transplantation were studied. The pretreatment regimens included malayan, cyclophosphamide and cytarabine. Results The median time of neutrophil and platelet activation was + 14d (10 ~ 19d) and + 13d (9 ~ 24d) respectively; acute graft versus host disease occurred in 4 of 30 (13.3% 9 cases (30%) had chronic graft-versus-host disease (cGVHD), 5 cases had hemorrhagic cystitis (16.7%) and 3 cases had interstitial pneumonia (10 cases) %). Oral mucositis occurred in 13 cases (43.3%). No hepatic veno-occlusive syndrome and epileptic convulsion occurred in 1 case. The median follow-up time was 36 days (170 ~ 160 days) and 3 cases (10 0%) relapsed. One patient died of graft-related complications (33%). Conclusions The BCA pretreatment regimen composed of marilan, cyclophosphamide and cytarabine has low toxicity, few related complications, safe and effective, and easy to implement.