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非清髓性异基因外周血造血干细胞移植治疗血液病的临床研究

[The clinical research of nonmyeloablative allogeneic peripheral blood hematopoietic stem cells transplantation for hematological diseases].

作者信息

Ai Hui-sheng, Yu Chang-lin, Wang Dan-hong, Guo Mei, Qiao Jian-hui, Shi Bao-fu, Sun Wan-jun, Zhang Shi, Sun Qi-yun, Yao Bo

机构信息

Affiliated Hospital, Chinese Academy of Military Medical Sciences, Beijing 100039, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2003 Feb;24(2):86-9.

Abstract

OBJECTIVE

To explore the significance of nonmyeloablative allogeneic peripheral blood hematopoietic stem cell transplantation in the treatment of hematological diseases.

METHODS

A nonmyeloablative conditioning regimen consisted of CD(3) monoclonal antibody, cyclosporine A, cyclophosphamide and cytarabine was used for allogeneic stem cell transplantation in 33 patients with hematological diseases. Of them, 11 were acute leukemia (AL) in first complete remission (CR(1)), 4 AL-CR(2) approximately 3, 3 refractory AL, 4 severe aplastic anemia (SAA), 7 chronic myeloid leukemia (CML), 2 myelodysplastic syndrome, 1 each of chronic lymphocytic leukemia (CLL) and myelofibrosis.

RESULTS

All 33 patients passed the hematopoietic suppression stage smoothly and achieved engraftment of the donor cells. There were 24 cases of full donor chimerism (13 cases converted from mixed chimerism), 4 mixed chimerism (MC) and 5 developed graft rejection. Of the 33 cases, 7 (21.2%) developed acute GVHD and chronic GVHD, 25 (75.8%) still live and 8 (24.2%) died.

CONCLUSIONS

Nonmyeloablative allogeneic peripheral blood stem cells transplantation is a safe, less toxic and curative approach for patients with hematological disease.

摘要

目的

探讨非清髓性异基因外周血造血干细胞移植在血液病治疗中的意义。

方法

采用由CD(3)单克隆抗体、环孢素A、环磷酰胺和阿糖胞苷组成的非清髓性预处理方案,对33例血液病患者进行异基因干细胞移植。其中,11例为首次完全缓解(CR(1))的急性白血病(AL),4例为约3个月的AL-CR(2),3例为难治性AL,4例为重型再生障碍性贫血(SAA),7例为慢性髓性白血病(CML),2例为骨髓增生异常综合征,慢性淋巴细胞白血病(CLL)和骨髓纤维化各1例。

结果

33例患者均顺利度过造血抑制期,实现供体细胞植入。完全供者嵌合24例(13例由混合嵌合转化而来),混合嵌合(MC)4例,发生移植物排斥5例。33例中,7例(21.2%)发生急性移植物抗宿主病(GVHD)和慢性GVHD,25例(75.8%)存活,8例(24.2%)死亡。

结论

非清髓性异基因外周血干细胞移植对血液病患者是一种安全、低毒且有治愈可能的方法。

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