Title

非T細胞去除HLA單倍體匹配造血幹細胞移植治療白血病

Translated Titles

Non-T cell-Depleted HLA Haploidentical Stem Cell Transplantation in Leukemia

Authors

吳漢新(Han-Xin Wu);李建勇(Jian-Yong Li);錢思軒(Si-Xuan Qian);任志宏(Zhi-Hong Ren);洪鳴(Ming Hong)

Key Words

白血病 ; 異基因造血幹細胞移植 ; 單倍體匹配 ; 移植物抗宿主病 ; leukemia ; allogeneic blood stem cells transplantation ; haploidentical ; graft versus host disease

PublicationName

南京醫科大學學報(自然科學版)

Volume or Term/Year and Month of Publication

24卷5期(2004 / 09 / 05)

Page #

491 - 494

Content Language

簡體中文

Chinese Abstract

目的:探討相關HLA單倍體匹配造血幹細胞移植治療白血病的療效及移植相關併發症。方法:4例白血病患者接受單倍體相合未去T細胞造血幹細胞移植,3例為HLA-A、B、DR3個位點不合親緣骨髓移植,1例為HLA-DR位點不合外周血造血幹細胞移植,3例移植時處於完全緩解(CR)期,1例處於慢性粒細胞白細病(CML)急變期,預處理採用阿糖胞苷+環磷酰胺(CTX)+全身照射(TBI),Graft versus host disease (GVHD)預防聯合使用環孢菌素A(CsA)、甲氨喋呤(MTX)、免抗人胸腺細胞球蛋白(ATG)、抗CD25單抗、黴酚酸酯(MMF)。結果:4例均獲得造血重建,植入直接證據檢測證實完全供者造血,3例無aGVHD,1例發生Ⅱ度腸道aGVHD,1例移植後3個月復發,2例在行供者淋巴細胞輸注治療後均併發了Ⅲ度腸道和Ⅱ度肝臟aGVHD,免疫重建延遲。至今,3例存活(+70天~+l9個月),均為持續完全緩解(CCR),1 例+11個月因感染死亡討論:未去T細胞單倍體相合HSCT造血重建穩定,移植相關併發症較少,重症GVHD發生率可能低。

English Abstract

Objective: To explore the efficiency and transplantation-related complications of HLA one or there locus mismatched related allogeneic blood stem cells transplantation for the treatment of leukemia. Methods: Four leukemia patients underwent haploidentical allogeneic blood stem transplanstation without ex -vivo T cell depletion. Three patients had HLA-A、B、DR locus mismatched and received related hone marrow transplanstation and one patient had one locus mismatched and received allogeneic peripheral blood stem cell transplantation. Three were in complete remission and one with chronic myeloid leukemia was in blast phase. The conditioning regimen included cytarabine, cyclophosphamide and total body irradiation (TBI). Graft versus host disease (GVHD) prophylaxis regimen consisted of cyclosporine (CsA), methotrexate (MTX), anti-CD25 monoclonal antibody and mycophenolate mofetil (MMF). Results: The four recipients had hematopoietic reconstitution, and cytogenetic analysis showed 100% donor hematopoietic cells in all recipients after transplantation. Immunologic reconstitution were postponed. Three recipients had no acute GVHD (aGVHD), and one had Ⅱ° aGVHD of intestinal tract .After three months, one recipient relapsed and, 2 patients had severe GVHD after donor lymphocyte infusion (DLI). Up to now, three recipients have continuous complete remission (CCR) and one recipient died of infection. Conclusion: In HLA-mismatched related allogeneic blood stem cells transplantation without ex-vivo T cell depletion, the hematopoietic reconstitution was earlier and more durable, but immunologic reconstitution was later. The transplantation-related complications were less and aGVHD may be milder.

Topic Category 醫藥衛生 > 醫藥衛生綜合
醫藥衛生 > 藥理醫學