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目的报道同胞间脐血移植(UCBT)成功治疗1例儿童难治性急性髓系白血病的疗效及治疗体会。方法急性髓系白血病M5a型8岁男性患儿1例,采用改良的白消安/环磷酰胺(BU/CY)方案预处理。回输人类白细胞抗原(HLA)配型完全相合胞妹的脐血干细胞,脐血有核细胞(NC)数:5.17×107/kg,其中集落形成细胞(CFC)数为10.33×104/kg,CD34+细胞数为1.25×105/kg。移植物抗宿主病(GVHD)的预防采用单用环胞素A(CsA)的方案。结果移植后+14d患者WBC>1.0×109/L,中性粒细胞绝对值(ANC)>0.5×109/L;+23dPLT>20×109/L,+35d性染色体检测显示为完全供者的染色体。移植后+85d未发生GVHD及其他并发症。结论UCBT是儿童高危白血病有效的治疗手段,而同胞间脐血移植则更为安全可靠。
Objective To report the efficacy and treatment of 1 case of refractory acute myeloid leukemia (UCBT) successfully treated by sibling cord blood transplantation (UCBT). Methods Acute myeloid leukemia M5a 8-year-old male with 1 case was pretreated with a modified busulfan / cyclophosphamide (BU / CY) regimen. Umbilical cord blood stem cells were completely transplanted to human leukocyte antigen (HLA) matching type. The number of cord blood nucleated cells (NC) was 5.17 × 107 / kg, the number of colony forming cells (CFC) was 10.33 × 104 / kg, The number of CD34 + cells was 1.25 × 10 5 / kg. Prevention of graft-versus-host disease (GVHD) A regimen of cyclosporine A alone (CsA) was used. Results The WBC> 1.0 × 109 / L, absolute neutrophil count (ANC)> 0.5 × 109 / L and + 23dPLT> 20 × 109 / L on + 14d posttransplantation showed sex chromosome at + 35d chromosome. GVHD and other complications did not occur 85 days after transplantation. Conclusion UCBT is an effective treatment for children with high-risk leukemia, while sibling cord blood transplantation is more safe and reliable.