[1]陈姝,李文,罗云,等.减低剂量Bu+Cy预处理方案进行异基因造血干细胞移植治疗白血病的效果观察[J].第三军医大学学报,2012,34(24):2442-2445.
 Chen Shu,Li Wen,Luo Yun,et al.Therapeutic effect of allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimen of Bu+Cy for leukemia[J].J Third Mil Med Univ,2012,34(24):2442-2445.
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
34卷
期数:
2012年第24期
页码:
2442-2445
栏目:
论著
出版日期:
2012-12-30

文章信息/Info

Title:
Therapeutic effect of allogeneic hematopoietic stem cell transplantation with reduced-intensity conditioning regimen of Bu+Cy for leukemia
作者:
陈姝李文罗云周慷张颖陈林邓建川娄世锋
重庆医科大学附属第二医院血液科
Author(s):
Chen Shu Li Wen Luo Yun Zhou Kang Zhang Ying Chen Lin Deng Jianchuan Lou Shifeng
Department of Hematology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, 400010, China
关键词:
白血病异基因造血干细胞移植预处理方案
Keywords:
leukemia allogeneic hematopoietic stem cell transplantation conditioning regimen
分类号:
R617;R730.53;R733.7
文献标志码:
A
摘要:
目的      观察采用减低剂量Bu+Cy预处理方案在白血病患者异基因造血干细胞移植中的应用价值。      方法      采用减低剂量Bu+Cy预处理方案:马利兰4 mg/(kg·d),3 d;环磷酰胺50 mg/(kg·d),2 d;兔抗胸腺细胞球蛋白(ATG)2.5 mg/(kg·d),2/4 d。行异基因造血干细胞移植治疗白血病共15例,其中急性淋巴细胞白血病2例,急性非淋巴细胞白血病3例,慢性粒细胞白血病9例,慢性粒细胞白血病急性粒细胞变1例。      结果      ①造血重建:患者均顺利植入,中性粒细胞>0.5×109/L的中位时间为12(10~17)d,血小板>20×109/L的中位时间为15(12~27)d。30 d行短串联重复序列复合扩增(STR-PCR)检测均为完全嵌合型。②移植相关并发症:15例患者中6例(40.0%)发生急性移植物抗宿主病(aGVHD),其中Ⅰ度2例,Ⅱ度4例,无Ⅲ~Ⅳ度;8例(53.3%)发生慢性移植物抗宿主病(cGVHD),其中广泛型2例,局限型6例;3例(20.0%)出血性膀胱炎;4例(26.7%)血巨细胞病毒感染。③复发及生存情况:随访中位时间15.4(6~30)个月,1例(6.7%)移植相关死亡,2例(13.3%)血液学复发,余12例(80.0%)无病存活6~30个月。      结论      减低剂量Bu+Cy预处理方案行异基因造血干细胞移植,造血重建快,移植并发症少,术后复发率低,且预处理相关死亡率低,是治疗白血病安全有效的方法。
Abstract:
Objective      To evaluate the clinical value of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with reduced intensity Bu+Cy conditioning regimen in the treatment of patients with leukemia.       Methods      The reduced intensity Bu+Cy conditioning regimen  including  busulfan (Bu) 4 mg/(kg·d) , for 3 d; cyclophosphamide (Cy) 50 mg/(kg·d), for 2 d, antithymocyte globulin (ATG) 2.5 mg/(kg·d), for 2/4 d,  were used in 15 leukemia patients who underwent allo-HSCT in our department from April 2010 to March 2012. There were 2 cases of acute lymphocytic leukemia, 3 cases of acute non-lymphoid leukemia, 9 cases of chronic myeloid leukemia, and 1 case of Crisis phase of CML.       Results      All patients achieved successful hemopoietic reconstruction. The median time of the neutrophil recovery >0.5×109/L was 12 (ranging from 10 to 17) d and the platelet recovery >20×109 /L was 15 (12 to 27) d after transplantation. In 15 patients, short tandem repeat polymerase chain reaction (STR-PCR) confirmed that the donor cells were fully implanted on day 30. Transplant-related complications were acute graft-versus-host disease (aGVHD) in 6 patients (40%) (2 patients with aGVHD=grade Ⅰ, 4 patients with aGVHD=grade Ⅱ, and none with aGVHD=grade Ⅲ-Ⅳ), chronic graft-versus-host disease (cGVHD) in 8 patients (53.3%) (2 cases of extensive-type, and 6 cases of limited-type), hemorrhagic cystitis in 3 patients (20%), and infected cytomegalovirus in 4 patients (26.7%). There was no other serious complication. All patients were followed up for a median time of 15.4 months (ranging from 6 to 30). One patient (6.7%) died of side effect related to the conditional regimen. Two patients (13.3%) got recurrence, and the rest (80.0%) survived event-free for 4 to 30 months.       Conclusion      After treated with reduced intensity Bu+Cy conditioning regimen-HSCT, leukemia patients have a better hematopoietic reconstitution and less transplant-related complications. It is also suggested that the pre-conditioning regimen has a low recurrence rate and a lower mortality. Therefore, this method maybe one of the safe and effective treatments for leukemia.

参考文献/References:

陈姝, 李文, 罗云, 等. 减低剂量Bu+Cy预处理方案进行异基因造血干细胞移植治疗白血病的效果观察[J]. 第三军医大学学报,2012,34(24):2442-2445.

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更新日期/Last Update: 2012-12-19