西安交通大学学报（医学版）Issue(2)：280-284,5.DOI:10.7652/jdyxb201502026
非血缘异基因造血干细胞移植治疗白血病21例临床观察
Clinical observation of 21 cases of unrelated donor hematopoietic stem cell transplantation for leukemia
王晓宁 1刘华胜 1王怀宇 1刘海波 1郭彩利 1孙春红 1张梅 1贺鹏程 1刘心 1陈丽梅 1王梦昌 1习杰英 1李静 1张海涛1
作者信息
- 1. 西安交通大学医学部第一附属医院血液内科，陕西西安 710061
- 折叠
摘要
Abstract
non-myeloablative BuCy+fludarabine conditioning regimen,and another one was treated with TBI+VP-1 6 +CTX+CCNU conditioning regimen.Only one case received short-term MTX,cyclosporin A and ATG regimen for prevention of graft-versus-host disease (GVHD).The GVHD prevention regimens of the other patients were based on short-term MTX,cyclosporin A,ATG and mycophenolate mofetil regimen.The hematopoietic reconstitution, complications and prognosis were observed.Results One patient died of intracranial hemorrhage,and hematopoi-etic reconstitution was achieved in the other 20 patients.The median time for hematopoietic reconstitution shortened by one day in large-dose group compared with that in low-dose group.Adverse reactions included high fever, shivering,gastrointestinal tract adverse reaction,liver injury,oral mucositis and other rare side effects.GVHD occurred more frequently in patients with HLA mismatched transplantation.Nine patients with aGVHD and 9 patients with cGVHD recovered after effective treatment.Within 100 days after transplantation,18 patients had bacterial or fungal infection,mainly upper respiratory tract infection;7 patients had cytomegalovirus infection;2 had EB viremia,and one had urinary BK virus infection.Only one patient died of VOD.Hemorrhagic cystitis occurred in 5 patients and improved after treatment.The median survival time was 24 months (ranging from 136 days to 9 years).One-year and 3-year overall survival rates were 85.2% and 63.9%,the disease free survival rates were 81% and 23.8%,recurrence free survival rates were 71.4% and 14.3%,respectively.Conclusion URD-HSCT was an effective method to treat leukemia.Conditioning regimen of BuCy and modified BuCy2 were safe and effective,the adverse reactions were reversible and well tolerated.Hematopoietic reconstitution time shortened in large-dose MNC and CD34 + cell number groups compared with that in low-dose group.The occurrence rate of GVHD with HLA mismatched transplantation was more than that of HLA matched transplantation.Low-dose heparin,prostaglandin E1 and Danshen injection can effectively prevent VOD.关键词
非血缘异基因造血干细胞移植/造血重建/移植物抗宿主病/出血性膀胱炎/肝静脉闭塞病Key words
unrelated allogeneic hematopoietic stem cell transplantation/hematopoietic reconstitution/graft versus host disease/hemorrhagic cystitis/hepatic venular occlusive disease分类
医药卫生引用本文复制引用
王晓宁,刘华胜,王怀宇,刘海波,郭彩利,孙春红,张梅,贺鹏程,刘心,陈丽梅,王梦昌,习杰英,李静,张海涛..非血缘异基因造血干细胞移植治疗白血病21例临床观察[J].西安交通大学学报（医学版）,2015,(2):280-284,5.
