本文選題：造血干細(xì)胞移植 + 急性髓系白血病　； 參考：《中國(guó)醫(yī)科大學(xué)學(xué)報(bào)》2017年01期

【摘要】：目的觀察異基因造血干細(xì)胞移植治療急性髓系白血病以及骨髓增生異常綜合征的療效和安全性。方法回顧性分析2011年4月至2016年4月在我院接受了異體造血干細(xì)胞移植的21例急性髓系白血病和8例骨髓增生異常綜合征病例。其中,人類白細(xì)胞抗原(HLA)全相合異基因移植16例,單倍體相合異基因移植10例,同基因移植3例。預(yù)處理方案采用Bu Cy2±化療,或全身照射(TBI)7.5~10 Gy聯(lián)合環(huán)磷酰胺120 mg/kg±化療。HLA全相合移植應(yīng)用環(huán)孢素聯(lián)合短程甲氨喋呤預(yù)防移植物抗宿主病(GVHD),單倍體相合移植采用兔抗人胸腺細(xì)胞球蛋白+環(huán)孢素+驍悉+甲氨喋呤+糖皮質(zhì)激素,同基因移植無(wú)需GVHD預(yù)防。結(jié)果所有患者獲得供者型造血重建。移植后100 d內(nèi)死亡2例,隨訪中位時(shí)間23個(gè)月(1~60個(gè)月)。Ⅱ~Ⅳ度急性GVHD發(fā)生率為23.1%(6/26),其中Ⅲ/Ⅳ度2例;慢性GVHD 50%,其中輕度c GVHD 3例,中度6例,重度4例。移植相關(guān)死亡率13.8%(4/29),復(fù)發(fā)死亡率20.7%(6/29),2年總體生存率68.09%(95%CI:45.77%~82.78%),無(wú)病生存率60.22%(95%CI:38.19%~76.55%)。生存分析顯示高�；颊呷源嬖谳^高復(fù)發(fā)風(fēng)險(xiǎn)。結(jié)論 HLA全相合及單倍體相合異基因造血干細(xì)胞移植是安全、有效、可行的。嚴(yán)密監(jiān)測(cè)高�；颊�,提前或及早干預(yù)是必要的,有利于進(jìn)一步提高移植療效。
[Abstract]:Objective to observe the efficacy and safety of allogeneic hematopoietic stem cell transplantation in the treatment of acute myeloid leukemia and myelodysplastic syndrome. Methods 21 cases of acute myeloid leukemia and 8 cases of myelodysplastic syndrome received allogeneic hematopoietic stem cell transplantation in our hospital from April 2011 to April 2016 were retrospectively analyzed. Among them, 16 cases were allogeneic transplantation, 10 cases were haploid allogeneic transplantation and 3 cases were syngeneic transplantation. Bu Cy2 鹵chemotherapy was used for pretreatment. Or TBI 7.5 ~ 10 Gy combined with cyclophosphamide 120 mg/kg 鹵chemotherapy.HLA homotransplantation with cyclosporine combined with short-course methotrexate to prevent graft-versus-host disease (GVHD), haploid matched transplantation with rabbit anti-human thymocyte globulin cyclosporine Mycophenolate mofetil methotrexate glucocorticoid, There is no need for GVHD to prevent homologous gene transplantation. Results all patients received donor hematopoietic reconstitution. Two patients died within 100 days after transplantation, and the median follow-up time was 23 months, ranging from 1 to 60 months. The incidence of acute GVHD of grade 鈪，

本文編號(hào)：1785434