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目的探讨异基因造血干细胞移植(Allo-HSCT)治疗B细胞性急性淋巴细胞白血病(B-ALL)的疗效。方法外周血Allo-HSCT治疗B-ALL 15例。预处理方案:6例为改良马利兰(BU)联合环磷酰胺(CY),9例为环磷酰胺/全身照射(TBI)。预防急性移植物抗宿主病(GVHD)采用环孢霉素A、短程甲氨喋呤及霉酚酸酯(骁悉)。结果输注单个核细胞5.36-12.30×108/kg,中性粒细胞大于0.5×109/L的为10-15d。血小板大于20×109/L的为11-16d。6例(40.0%)发生急性GVHD,6例(40.0%)发生慢性GVHD,皆为广泛性。中位随访时间14个月(2.5-65个月),9例患者无病生存。结论 Allo-HSCT可以作为治疗成人B-ALL的有效手段。
Objective To investigate the efficacy of Allo-HSCT in the treatment of B-cell acute lymphoblastic leukemia (B-ALL). Methods Peripheral blood Allo-HSCT treatment of B-ALL in 15 cases. Pretreatment regimen: Six patients were treated with Modified Marilla (BU) combined with cyclophosphamide (CY) and nine with cyclophosphamide / total body irradiation (TBI). Cyclosporine A, short-course methotrexate and mycophenolate mofetil are used to prevent acute graft-versus-host disease (GVHD). Results Infusion of mononuclear cells 5.36-12.30 × 108 / kg, neutrophils greater than 0.5 × 109 / L for 10-15d. Platelets greater than 20 × 109 / L for the 11-16d. Six cases (40.0%) developed acute GVHD and six (40.0%) developed chronic GVHD, all of which were extensive. The median follow-up time was 14 months (2.5-65 months) and 9 patients were disease-free. Conclusion Allo-HSCT can be used as an effective treatment of adult B-ALL.