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目的 :为减少白血病患者自体骨髓移植后白血病复发率和提高长期无病存活率。方法 :采用缓解期急性非淋巴细胞白血病患者的骨髓细胞在体外经处理后用癌光啉 (浓度为 10 μg/ ml)加光照净化 ,待患者完成预处理后回输给自身。结果 :10例急性髓细胞白血病患者接受了本净化方法后移植治疗。净化后输入有核细胞中位数1.3 0 ( 0 .7～ 2 .4 5 )× 10 8/ kg,CD3 4+ 细胞中位数 2 .3 9( 0 .74～ 4 .0 6)× 10 6/ kg,CFU- GM中位数 1.4 4( 0 .3 2～4 .65 )× 10 4/ kg。 10例中 9例造血功能重建 ,WBC升到 >1.0× 10 9/ L中位数时间 2 0 ( 15～ 4 3 ) d,>2 .0×10 9/ L 中位数时间 3 0 ( 2 1～ 5 5 ) d,BPC>5 0× 10 9/ L 中位数时间 4 6( 2 5～ 62 ) d。经中位 2 6个 ( 2 0～ 64 )月随访 ,有 6例仍无病存活 ;3例复发 ,其中 2例复发后失去随访 ;1例嗜碱细胞性白血病经化疗再次取得缓解 ,至今 CR2后又无复发存活 14个月 ;1例死于与移植相关并发症。结论 :初步结果表明 ,用癌光啉加光照净化自体骨髓中残留白血病细胞后行自体骨髓移植治疗白血病是一种安全而有潜力的方法
Objective: To reduce the leukemia recurrence rate and long-term disease-free survival rate in patients with leukemia after autologous bone marrow transplantation. METHODS: Bone marrow cells from patients with acute non-lymphocytic leukemia during remission were treated with cancer photopheresis (concentration 10 μg / ml) plus photopheresis after in vitro treatment. Patients were pretreated and returned to themselves. Results: Ten patients with acute myeloid leukemia received the debridement after the purification method. After purification, the median of nucleated cells was 1.3 0 (0.7-2.45) × 10 8 / kg and the median of CD3 4+ cells was 2.39 (0.74-4.06) × 10 6 / kg, CFU-GM median 1.4 4 (0.32 ~ 4.65) × 10 4 / kg. Nine of 10 patients underwent hematopoietic reconstitution. WBC rose to> 1.0 × 10 9 / L median time 20 (15-4 3) d,> 2.0 × 10 9 / L median time 30 1 ~ 5 5) d, BPC> 5 0 × 10 9 / L median time 4 6 (2 5 ~ 62) d. After 6 months (20 ~ 64) months of follow-up, 6 patients were still alive without disease; 3 patients relapsed, 2 patients were lost after follow-up and 1 patient with basophilic leukemia remitted again by chemotherapy. CR2 And then no recurrence of survival for 14 months; 1 died of complications related to transplantation. CONCLUSIONS: The preliminary results indicate that the safe and potential method of autologous bone marrow transplantation for the treatment of leukemia after the residual leukemic cells in autologous bone marrow is treated with cancer photophor and light irradiation