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目的 :评价自体造血干细胞移植 (AHSCT)治疗急性白血病的疗效。方法 :采用AHSCT治疗急性白血病 13例 ,中位年龄 19( 7～ 40 )岁。其中急性非淋巴细胞白血病 (ANLL) 6例 ,急性淋巴细胞白血病 (ALL) 7例。CR1后移植 9例 ,CR2后移植 4例。预处理选用以MAC(Melphalan 14 0～ 180mg/m2 × 1d ;Ara C 1 0～ 2 0mg/m2 × 2d ;CTX 60mg/kg× 2d)为主的方案 ,其中 6例在经典MAC的基础上改用马法兰口服为静注 ,并有 3例同时加用CCNU( 5mg/kg× 1d)及VP16( 60 0mg/m2 × 1d)。另 3例次采用TACC为主的预处理。结果 :所有患者移植后均重建造血 ,平均存活时间为 2 9个月 ( 2～ 132个月 )。 9例CR 1期移植者 3年无病生存为 4例 ,5年DFS为 3例。结论 :为降低白血病复发率和提高患者无病生存率 ,无骨髓供者的CR 1期急性白血病患者适合接受ABMT。
Objective: To evaluate the efficacy of autologous hematopoietic stem cell transplantation (AHSCT) in the treatment of acute leukemia. Methods: Thirteen patients with acute leukemia were treated with AHSCT. The median age was 19 (7-40) years. Among them, 6 were acute nonlymphocytic leukemia (ANLL) and 7 were acute lymphoblastic leukemia (ALL). Nine patients received CR1 transplantation and 4 patients received CR2 transplantation. The pretreatment was based on the MAC (Melphalan 14 0-180mg/m2 × 1d; Ara C 1 0-200mg/m 2 × 2d; CTX 60mg/kg × 2d)-based regimen, of which 6 were based on the classic MAC Oral administration was carried out with melphalan for intravenous injection, and 3 patients were simultaneously treated with CCNU (5 mg/kg×1 d) and VP16 (60 mg/m2 × 1 d). The other three cases used TACC-based pretreatment. RESULTS: All patients were reconstituted with blood after transplantation. The average survival time was 29 months (2 to 132 months). Nine cases of CR stage 1 transplantation had 3 cases of disease-free survival in 4 cases and 5 years of DFS in 3 cases. Conclusions: In order to reduce the recurrence rate of leukemia and increase the disease-free survival rate of patients, patients with CR stage 1 acute leukemia without bone marrow donors are eligible for ABMT.