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不同临床分期慢性髓系白血病的自体造血干细胞移植

Autologous hematopoietic stem cell transplantation in chronic myeloid leukemia with different clinical stages.

作者信息

Gopcsa L, Barta A, Banyai A, Foldi J, Kalasz L, Pajor L, Gidali J, Regeczy N, Paloczi K

机构信息

National Institute of Haematology and Immunology, Budapest, Hungary.

出版信息

Acta Haematol. 2001;106(3):100-5. doi: 10.1159/000046597.

Abstract

Seven patients with Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML) were treated with an ICE-based regimen plus G-CSF with the aim of mobilizing and collecting Ph-negative peripheral stem cells in the setting of an autologous transplant program. Five patients had CML in the first chronic phase and 2 in the accelerated phase. All patients had been previously treated with interferon-alpha. Median value and ranges for harvested mononuclear cells, CD34+ cells and CFU-GM, respectively: 5.65 x 10(8)/kg (2.61-11.38); 1.48 x 10(6)/kg (0.216-3.5), and 3.43 x 10(4)/kg (0.243-11.6). FISH was the only useful method for detection of minimal residual disease on apheresis product showing <5% t(9;22) positive cells in 2 cases and <10% positive cells in 4 other cases. Four of seven autologous grafts have been transplanted to date. Busulfan conditioning was used in 1 case and TBI/Cy conditioning in 3 other cases. All patients are alive and well following transplantation and are on interferon-alpha therapy.

摘要

七名费城(Ph)染色体阳性慢性髓性白血病(CML)患者接受了基于ICE的方案加粒细胞集落刺激因子(G-CSF)治疗,目的是在自体移植计划中动员并采集Ph阴性外周血干细胞。五名患者处于慢性期,两名处于加速期。所有患者此前均接受过α干扰素治疗。采集的单个核细胞、CD34+细胞和粒-巨噬细胞集落形成单位(CFU-GM)的中位数及范围分别为:5.65×10⁸/kg(2.61 - 11.38);1.48×10⁶/kg(0.216 - 3.5),以及3.43×10⁴/kg(0.243 - 11.6)。荧光原位杂交(FISH)是检测单采产品中微小残留病的唯一有效方法,结果显示2例t(9;22)阳性细胞<5%,另外4例阳性细胞<10%。截至目前,七例自体移植物中有四例已进行移植。1例采用白消安预处理,另外3例采用全身照射/环磷酰胺预处理。所有患者移植后均存活且状况良好,目前正在接受α干扰素治疗。

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