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为观察异基因外周血造血干细胞移植 (allo PBSCT)治疗急慢性白血病的疗效 ,从 1997年 3月至 2 0 0 3年 1月共进行了 2 1例急慢性白血病的Allo PBSCT。 2 1例的供者中 19例为HLA Ⅰ /Ⅱ抗原完全相合的同胞 ,1例慢性粒细胞白血病急粒变患者的供者为HLA半相合母亲 ,1例女性急性淋巴细胞白血病患者的供者为 1个B位点不合的胞妹。 2 1名供者均用rhG CSF动员 ,第 5天起用CS 3 0 0 0plus分离外周血单个核细胞 1-3次 ,预处理方案采用常用的TBI与联合化疗方案。所有病人均采用环胞菌素A和短程MTX进行移植物抗宿主病的预防。结果表明 ,移植后粒细胞恢复至≥ 0 .5× 10 9/L平均为 12天 ,血小板恢复至≥ 2 0× 10 9/L为 15天。 17例患者中发生急性GVHD 8例 (47% ) ,其中 1例为子母间移植 ;慢性GVHD 12例 (70 % ) ;4例存活的女性患者 ,包括 1例 1个B位点不合的ALL患者 ,均无急、慢性GVHD发生。 10 0天移植相关死亡 3例 (14 % ) ,复发 2例 (9.5% ) ,均为移植时未缓解患者。至报告时无病存活 11例 (52 .4% ) ,存活时间平均 40 (15-70 )个月。结论 :Allo PBSCT后造血恢复较快、白血病复发率相对较低 ,急性和重度GVHD的发生并无明显增加 ,但慢性GVHD发生率明显增高 ,并成为影响患者生存的主要并发症
To observe the efficacy of allo PBSCT in the treatment of acute and chronic leukemia, 21 allo PBSCT patients with acute and chronic leukemia were performed from March 1997 to January 2003. Nineteen of the 21 donors were HLA-Ⅱ / Ⅱ antigen-fully matched siblings. One donor with chronic myeloid leukemia and acute granulopathy was HLA haplotype mother, and one donor with acute lymphoblastic leukemia For a B-site incompatible sister. Twenty-one donors were mobilized with rhG-CSF. Peripheral blood mononuclear cells were isolated 1-3 times with CS 30000 on the 5th day. The pretreatment regimen used commonly used TBI and combination chemotherapy. All patients were treated with cyclosporine A and short-range MTX for graft-versus-host disease prevention. The results showed that the average number of granulocytes recovered to ≥ 0. 5 × 10 9 / L after transplantation was 12 days and the platelets returned to ≥ 20 × 10 9 / L for 15 days. Acute GVHD occurred in 17 patients (47%), of which 1 was maternal-to-mother; 12 (70%) had chronic GVHD; 4 survived women, including 1 patient with one B-site ALL Patients, no acute and chronic GVHD occurred. There were 3 deaths (14%) and 2 recurrent cases (9.5%) in 100 days, all of which were not relieved at the time of transplantation. There were 11 cases (52.4%) without disease-free survival at the time of reporting, and the average survival time was 40 (15-70) months. CONCLUSION: After Allo PBSCT hematopoietic recovery is rapid, the relapse rate of leukemia is relatively low, the incidence of acute and severe GVHD is not significantly increased, but the incidence of chronic GVHD is significantly increased, and become a major complication of survival in patients