非清髓性异基因造血干细胞移植治疗恶性血液病26例论文.docVIP

　　非清髓性异基因造血干细胞移植治疗恶性血液病26例论文 .freelyeloablative allogeneic stem cell transplantation，allo-NST）治疗恶性血液病的疗效及相关技术，选择26例恶性血液病患者作为研究对象（急性白血病10例，慢性髓性白血病14例，多发性骨髓瘤2例），其中14例采用FAC（fludarabin+ATG+Cy)预处理，12例采用MAC（melfalan/maleran+ATG+Cy)预处理；用G-CSF 600 μg/d或G-CSF 300 μg/d+GM-CSF 300μg/d进行外周血干细胞动员，于第5天开始用Cobe Spectra血细胞分离机连续采集2-3次；用环孢菌素A联合短程甲氨蝶呤预防GVHD；移植后第4周开始供体淋巴细胞输注，首剂1×107/kg，之后依据临床反应及嵌合体形成情况，每4周1次，剂量逐级递增；微卫星短串联重复序列（STR）分析、Bcr/Abl融合基因、Ph染色体、HLA位点分析、性染色体及ABO血型等为植活检测指标。结果显示： 植入率84.62%，aGVHD发生率11.54%，cGVHD发生率23.07%；感染和出血等毒副反应发生率低、反应轻。结论：非清髓性异基因造血干细胞移植治疗恶性血液病疗效确切，毒副作用小，但相关技术，如适应症的选择、预处理方案、移植过程中的免疫治疗等需要进一步深入研究。 【关键词】 造血干细胞移植；非清髓性异基因造血干细胞移植； 恶性血液病 Nonmyeloablative Allogeneic Hematopoietic Stem cell Transplantation in 26 Cases of Hematological Malignancies Abstract The purpose of this study yeloablative allogeneic stem cell transplantation (allo-NST) and its related technologies in hematological malignancies. 26 patients atological malignancies (acute leukemia 10，chronic myeloid leukemia 14，multiple myeloma 2) received allo-NST folloens ide/ATG in 14 cases or busulfan or melphalan/ cyclophosphamide/ATG in 12 cases prior to infusion of 2 or 3 collections of G-CSF(600 μg/d) or G-CSF(300 μg/d) plus GM-CSF(300 μg/d) mobilized blood stem cell on the fifth day. A bination of cyclosporine A (CsA) and methotrexate(MTX) inistered for GVHD prophylaxis. Patients phocyte infusion (DLI) (or donor stem cell infusion (DSI) )given in graded increments according to the chimeric formation and clinical feature. Generally，the dose of the first infusion ent analyses included the detection of microsatellite short tandem repeats (STRs)，bcr/abl fusion gene，Philadelphia chromosome，HLA-locus analysis，sex chromosome and ABO blood type or blood subtype. The results shoerism (FDC) up to noorrhage atological malignancies，en and transplantation immunotherapy should be studied further. Key atopoietic stem cell transplantation; nonmyeloablative allogeneic hematopotetic stem cell transplantation; hematological ma