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为尽可能将采集的自体外周血造血干细胞中肿瘤细胞污染的程度减少到最低、尽可能去除引起移植物抗宿主病(GVHD)的效应细胞 -T细胞 ,以避免父子/母子之间半相合移植后发生严重GVHD可能 ,2例Ph( + )染色体的高危急淋和1例复发急淋被进行自体/异体CD34+ 细胞纯化移植。移植治疗后 :3例病儿全部获得血液系统恢复 ,2例异体移植仅出现轻度的I°-II°GVHD ,STR位点DNA检验以及染色体检查证实均植入成功。病情转归 :1例自体移植于移植后16个月复发 ;1例异体移植于87天感染病毒性多发性神经根炎死亡 ;1例异体移植目前为移植后17个月 ,多次复查骨穿 ,均提示处于缓解状态 ,Ph染色体和bcr/abl基因仍为阴性。结果表明 ,CD34 +细胞移植可以克服异体移植时HLA部分不相配的难点 ,减轻GVHD ;自体CD34+ 细胞移植虽然减少了植入的污染细胞 ,但由于缺乏移植物抗白血病反应 ,移植后仍然有体内白血病细胞复发可能 ,仍然需要维持治疗。
In order to minimize the degree of tumor cell contamination in the collected autologous peripheral blood hematopoietic stem cells, try to remove effector cells-T cells that cause graft-versus-host disease (GVHD) as much as possible in order to avoid semi-coincidence transplantation between father and son After severe GVHD, 2 cases of Ph (+) chromosome high-risk acute lymph node and 1 case of recurrent acute lymphoblastic leukemia were autologous / allogeneic CD34 + cells were transplanted. After transplantation, all 3 cases of children were hematopoietic recovered, 2 cases of allogeneic transplantation only mild I ° -II ° GVHD, STR locus DNA test and chromosomal examination confirmed the successful implantation. One case of autotransplantation recurred 16 months after transplantation. One case died of viral multiple neuritis after being infected for 87 days. One case of allotransplantation was currently 17 months after transplantation. , All showed that the Ph chromosome and bcr / abl gene were still negative. The results showed that CD34 + cell transplantation could overcome the difficulty of HLA mismatch in allogeneic transplantation and alleviate GVHD. Autologous CD34 + cell transplantation reduced the number of implanted cells but still had leukemia after transplantation due to the lack of graft-versus-leukemia Cell recurrence may, still need to maintain treatment.