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目的探讨外周血造血干细胞移植(PBSCT)技术治疗恶性血液病的疗效及安全性。方法 51例恶性血液病患者中,34例行亲缘全相合异基因PBSCT(allo-PBSCT);5例行亲缘半相合allo-PBSCT,12例行自体PBSCT。结果全部患者均成功植入并快速重建造血。亲缘全相合allo-PBSCT中Ⅰ～Ⅱ度急性GVHD的发生率为26.4%,未见Ⅲ～Ⅳ度急性GVHD;慢性GVHD的发生率为54.1%。亲缘半相合allo-PBSCT中Ⅰ～Ⅲ度急性GVHD的发生率为32.1%,未见Ⅳ度急性GVHD;慢性GVHD的发生率为74.5%。本组死亡11例,总病死率为21.6%。结论 auto-PBSCT、亲缘HLA配型完全相合与半相合allo-PBSCT均具有造血重建快、aGVHD发生率较低、疗效较好、安全可行及住院时间短的优点,尤其亲缘半相合allo-PBSCT为难治性白血病患者开辟了新的治疗途径。
Objective To investigate the efficacy and safety of peripheral blood stem cell transplantation (PBSCT) in the treatment of hematologic malignancies. Methods Totally 51 patients with hematologic malignancies were treated with allogeneic PBSCT (allo-PBSCT), 5 with matched allo-PBSCT and 12 with autologous PBSCT. Results All patients were successfully implanted and reconstructed quickly. The incidence of acute GVHD with stage Ⅰ ~ Ⅱ degree in allo-PBSCT was 26.4%. There was no acute GVHD with Ⅲ ~ Ⅳ degree. The incidence of chronic GVHD was 54.1%. The incidence of grade Ⅰ ~ Ⅲ acute GVHD in allo-PBSCT was 32.1%. No grade Ⅳ acute GVHD was observed. The incidence of chronic GVHD was 74.5%. The group died of 11 cases, the total case fatality rate was 21.6%. Conclusion Both auto-PBSCT, matched HLA haploidentical and haploidentical allo-PBSCT have the advantages of fast hematopoietic reconstitution, low incidence of aGVHD, good curative effect, safe and feasible, and short hospital stay, especially for the haploidentical allo-PBSCT Patients with leukemia have opened up new avenues of treatment.