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目的观察异基因外周血干细胞移植治疗难治性恶性血液病的疗效。方法应用Ｇ（Ｍ）－ＣＳＦ动员的ＨＬＡ完全相合同胞（５例）和半相合亲属（１例）外周血干细胞移植治疗６例难治性恶性血液病，包括３例慢性粒细胞白血病（２例加速期，１例急变耐药），从未缓解和耐药复发淋巴瘤各１例，１例急性淋巴细胞白血病第３次复发。移植前预处理方案为高剂量联合化疗加全身照射。移植的单个核细胞、ＧＭ－ＣＦＵ和ＣＤ＋３４细胞平均分别为４．９×１０８／ｋｇ、１２．５×１０４／ｋｇ和４．２×１０６／ｋｇ。结果移植后造血功能皆重建。染色体、红细胞血型及亚型检查证实均移植成功。２例发生Ⅱ度急性ＧＶＨＤ，３例发生慢性ＧＶＨＤ，经治疗很快控制。６例的原发病皆达完全缓解，且随访至今４例无病存活，２例ＣＣＲ＋５８ｄ和＋１１８ｄ后分别死于间质性肺炎和心肌病。结论异基因外周血干细胞移植是治疗晚期恶性血液病的较好选择，加强对移植后并发症的防治，可望获得长期生存率。
Objective To observe the efficacy of allogeneic peripheral blood stem cell transplantation in the treatment of refractory hematological malignancies. Methods Six cases of refractory hematological malignancies were treated with G(M)-CSF-mobilized HLA-completely matched siblings (5 cases) and haploidentical relatives (1 case) peripheral blood stem cell transplantation, including 3 cases of chronic myeloid leukemia (2 cases). Accelerated phase, 1 case of sudden change drug resistance), never remission of drug-resistant and relapsed lymphoma in 1 case, and 1 case of acute lymphoblastic leukemia in the 3rd relapse. The pretreatment plan for transplantation was high-dose chemotherapy combined with whole body irradiation. The average number of transplanted mononuclear cells, GM-CFU, and CD+34 cells was 4.9 x 108/kg, 12.5 x 104/kg, and 4.2 x 106/kg, respectively. Results The hematopoietic function was reconstructed after transplantation. Chromosomes, red blood cell types and subtypes confirmed successful transplantation. Two cases of acute GVHD occurred in degree II, and 3 cases developed chronic GVHD, which was quickly controlled after treatment. All 6 cases had complete remission of the primary disease, and 4 cases survived until the end of the follow-up and 2 cases died of interstitial pneumonia and cardiomyopathy after CCR+58d and +118d respectively. Conclusion Allogeneic peripheral blood stem cell transplantation is a good choice for the treatment of advanced hematological malignancies. It can strengthen the prevention and treatment of post-transplant complications and is expected to achieve long-term survival.