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为了评价异基因外周血造血干细胞移植 (allo PBSCT)治疗慢性髓细胞白血病 (CML)的疗效 ,作者对 12例CML进行了allo PBSCT的临床研究 ,12例均为第 1次慢性期 ,中位年龄 32 .5岁 ;全部供受者HLA配型完全相合 ,供者动员用G CSF 5 μg/ (kg·d)× 5天 ,分离外周血单个核细胞 (2 .49.5 7)× 10 8/kg(中位数 5 .0× 10 8/kg) ,CD 34 + 细胞数为 (0 .72 6 6 .30 )× 10 6/kg(中位数 5 .82× 10 6/kg)。预处理方案 :9例采用全身照射 (TBI) +环磷酰胺 (CTX) +依托泊甙 (VP16 ) ,3例采用TBI +CTX ;移植物抗宿主病 (GVHD)预防采用环孢素A(CsA) +短程甲氨喋呤 (MTX)方案。全部患者均顺利造血重建 ,中性粒细胞 >0 .5× 10 9/L中位数 14.5天 (142 3天 ) ,血小板 >2 0× 10 9/L中位数 16天 ;发生Ⅱ度以上急性GVHD 3例 (2 5 % ) ;慢性GVHD共 5例 ,其中局限性 3例 ,广泛性 2例 ;死亡 3例 ,2例死于感染 ,1例死于间质性肺炎 ,中位随访 6个月 ,存活 9例。Allo PBSCT急性GVHD发生率并不比异基因骨髓移植高 ,但慢性GVHD的发生应引起重视
To evaluate the efficacy of allogeneic peripheral blood stem cell transplantation (allo PBSCT) in the treatment of chronic myeloid leukemia (CML), the authors performed a clinical study of allo-PBSCT in 12 patients with CML. All 12 patients were in the first chronic phase, and the median age was 1. 32. 5 years old; HLA matching of all donors and recipients is fully consistent, donor mobilized with G CSF 5 μg/ (kg·d) × 5 days, isolated peripheral blood mononuclear cells (2.45 7) × 10 8/kg (median 5 .0×10 8 /kg), the number of CD 34 + cells was (0.772 6.30) × 10 6/kg (median 5.82×10 6 /kg). Pretreatment protocol: 9 patients were treated with total body irradiation (TBI) + cyclophosphamide (CTX) + etoposide (VP16) and 3 patients were treated with TBI + CTX; prevention of graft-versus-host disease (GVHD) with cyclosporine A (CsA) ) + Short-term Methotrexate (MTX) regimen. Smooth hematopoietic reconstitution was achieved in all patients, with a median neutrophil population of >0.5×10 9/L, 14.5 days (142 days), and a platelet count of >2 0×10 9/L, a median of 16 days; Acute GVHD in 3 cases (25%); chronic GVHD in 5 cases, including localized in 3 cases, extensive in 2 cases; death in 3 cases, 2 cases died of infection, 1 case died of interstitial pneumonia, and a median follow-up of 6 Months, 9 cases survived. The incidence of acute GVHD in Allo PBSCT is not higher than allogeneic bone marrow transplantation, but the occurrence of chronic GVHD should be considered