双次自体外周血干细胞移植治疗多发性骨髓瘤_临床医学论文.docVIP

双次自体外周血干细胞移植治疗多发性骨髓瘤_临床医学论文 双次自体外周血干细胞移植治疗多发性骨髓瘤_临床医学论文 作者：张小荣， 苏丽萍， 许莲蓉， 朱秋娟 【摘要】 为了探讨双次自体外周血干细胞移植治疗多发性骨髓瘤(MM)的安全性及疗效，为1例49岁女性MM患者行双次自体外周血干细胞移植。第1次移植的动员方案：环磷酰胺2 g/m2 ×1天,粒细胞集落刺激因子（G）［(10 μg/(kg·d)］×5天。预处理方案：马法兰（melphalan）200 mg/m2。自体外周血干细胞回输：单个核细胞（MNC）6.1×108/kg；CD34+细胞 4.7×106/kg 。6个月后行第2次移植的动员方案：G［(10 μg/(kg·d)］×5天。预处理方案：马法兰200 mg/m2。自体外周血干细胞回输： MNC 10.2×108/kg；CD34+细胞 5.9×106/kg。结果表明：第1次移植后17天中性粒细胞绝对值（ANC）回升至0.5×109/L， 15天血小板回升至20×109/L； 第2次移植后22天ANC回升至0.5×109/L， 13天血小板回升至20×109/L。双次移植过程中均未出现明显毒副反应，无严重并发症。经上述治疗后患者的骨痛、贫血症状消失，第2次移植后随访7个月，患者情况良好，仍处于完全缓解（CR）状态。结论: 双次自体外周血干细胞移植治疗多发性骨髓瘤是安全、有效和可行的。 【关键词】 多发性骨髓瘤 Double Times of Autologous Peripheral Blood Stem Cell Transplantation to Treat Multiple Myeloma Abstract In order to explore the security and feasibility of double autologous peripheral blood stem cell transplantation (APBSCT) for treatment of multiple myeloma, a 49 years old female patient with multiple myeloma was therapied with double APBSCT . The first peripheral blood stem cell (PBSC) mobilization regimen included CTX 2 g/m2 ×1d and GCSF ［10 μg/(kg·d)］×5 d. The conditioning regimen was given melphalan 200 mg/m2. The transplanted number of mononuclear cells was 6.1×108/kg and that of CD34+ cells was 4.7×106/kg. The second APBSCT was performed six months later. PBSC mobilization regimen was GCSF ［10 μg/(kg·d)］×5 d. The conditioning regimen was melphalan 200 mg/m2. The transplanted number of mononuclear cells was 10.2×108/kg and that of CD34+ cells was 5.9×106/kg. The results showed that the absolute neutrophil count (ANC) rose to above 0.5×109/L on day 17 and platelet count exceeded 20×109/L on day 15 after first transplantation. After second transplantation ANC rose to above 0.5×109/L on day 22 and platelet count exceeded 20×109/L on day 13. There were neither obvious adverse reaction nor severe complication during the double transplantations. The patients ostealgia and anemia were healed through above therapy. In the followup of 7 months, the patients