中国组织工程研究与临床康复2011，Vol.15Issue(49)：9307-9310,4.DOI:10.3969/j.issn.1673-8225.2011.49.044
非清髓性异基因造血干细胞移植治疗高龄白血病
Non-myeloablative allogeneic hematopoietic stem cells transplantation for the treatment of elderly patients with acute leukemia
陆婧媛 1鹿全意1
作者信息
- 1. 福建医科大学协和临床医学院,厦门中山医院,福建省厦门市,361004
- 折叠
摘要
Abstract
BACKGROUND: N on-myeloablative allogeneic hematopoietic stem celb transplantation can reduce the mtereiV of conditioning regimen, and decrease the transplantation related mortality rate.OBJECTIVE: To analyze the efficacy and safety of non-myeloablatcVe allogeneic hematopoieticstem celts transplantation for the treatment of elderly patients with acute leukemia.METHOOS: A71-year-old female patient with acute mononuclear cell leukemia M5b undeiwentthe non-myeloablatwe allogeneic hematopoieticstem cells transplantation. The donor was the younger brother of the patient who was 60 years old. ABO blood type was the same and the HLA loci were mismatched. The conditioning regimen contained fludarabine, thiotepa, cyclophosphamideand Myleran, human anti-thymocyteglobuli^ATO). Basilcximab, cyclosporine, mycophenolate mofetiland gamma globulin were used for graft-versus-host disease(OVH0) prophylaxis. The prophylaxis and support therapy of complication after transplantation consisted ofGanciclovirfor cytomegaloviius infection, prostaglandin El. Salvia Mittiorrhoa; Heparin and ursodeoxycholic acid forveno-occlusrVe disease: Granulocyte colony-stimulating factor (O-CSF) 5 ugkgperday was used when the absolute neutrophil count decreased to O.5x 109/L. Red cells and platelet were infused if necessary. Peripheral blood stem cells (P8SC) of the donor were mobilized with O-CSF for 7 successes days. PBSCwere collected and infused to the patient at the 6 and 7 days.RESULT SANO CONCLUSION: Hemopoiesis and immunology reconstruction was completed at the 28* day after trareplantaSon. R suite of short tandem repeat (STR) detection shews that the ON Afrom the donor was the same as the patient at the 50* day after transplantation. The patient suffered from hemorrhagic cystitis and sepsis (Burkholderiacepacia) after transplantation for 20-30 days. Two months later, the patient presented with jaundice and hepatic impairment and she was diagnosed as having acute OVHD (livet. Grade 3). These were controlled with antibiotics and adjusting the regime of immunosuppressive drugs. These findings indicate that non-myeloablatcVe allogeneic hematopoieticstem cells transplantation based on a pretreatment regime containing fludarabine is safe and effedcVefor elderly acute leukemia patients with a variety of complications.关键词
白血病/造血干细胞移植/异基因/非清髓性/并发症分类
医药卫生引用本文复制引用
陆婧媛,鹿全意..非清髓性异基因造血干细胞移植治疗高龄白血病[J].中国组织工程研究与临床康复,2011,15(49):9307-9310,4.
