| 摘要: |
| ［摘要］ 目的 评价异基因外周血造血干细胞移植(allo-PBSCT)治疗急性单核细胞白血病（M5）的疗效，并探讨其并发症的预防及处理。方法 16例M5患者接受allo-PBSCT，其中亲缘11例，非亲缘5例。预处理方案：9例采用清髓方案BUCY，7例采用非清髓方案FBC。亲缘的11例均采用环孢素+短程甲氨蝶呤预防移植物抗宿主病（GVHD），非亲缘的5例均采用环孢素+甲氨蝶呤+吗替麦考酚酯+ATG。输注的外周血干细胞有核细胞中位数为6.58×108/kg，CD34+细胞中位数为4.46×106/kg。结果 16例患者中15例均证实植活,余1例在移植早期因HVOD死亡。植入病人中白细胞植入中位时间为13（9～17）d，血小板>20×109/L的中位时间为16（8～26）d。发生急性GVHD 6例（Ⅰ度4例，Ⅱ度2例），发生局限性慢性GVHD 7例。目前无病存活10例，中位生存期为45（3～78）个月。结论 Allo-PBSCT是治疗M5的有效手段，并发症少，能有效延长患者生存时间。 |
| 关键词: 造血干细胞移植 急性单核细胞白血病 疗效 |
| DOI：10.3969/j.issn.1674-3806.2013.09.02 |
| 分类号:R 55 |
| 基金项目:广州市医药卫生科技项目（编号：201102A213087） |
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| A clinical observation of allogeneic peripheral blood hematopoietic stem cells transplantation for acute monocytic leukemia |
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LI Yu-miao，MAO Ping，WANG Shun-qing, et al.
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Department of Hematology, Guangzhou First People′s Hospital, Guangzhou Medical University,Guangdong 510180,China
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| Abstract: |
| ［Abstract］ Objective To study the therapeutic effectiveness and associated complications of allogeneic peripheral blood stem cells transplantation(Allo-PBSCT)in treatment of acute monocytic leukemia（M5）.Methods Sixteen patients with acute monocytic leukemia received allo-PBSCT,11 patients received PBSCT from human leucocyte antigen（HLA）-matched sibling donors and 5 from HLA-matched unrelated donors. Pre-Processing regimen: 9 patients were subjected to modified BU/CY2 regimen which was myeloablative， another 7 patients were subjected to FBC regimen which was non-myeloablative. The graft-versus-host disease(GVHD) was prevented by cyclosporin A（CsA），short-term methotrexate（MTX）in 11 patients who received PBSCT from HLA-matched sibling donors, and another 5 patients additionally received antithymocyte globulin(ATG) and mycophenolate mofetil(MMF).A median of 6.58×108/kg nucleated cells and 4.46×106/kg CD34+ cells were transfused.Results Except for 1 patient died early after transplantation because of hepatic veno-occlusie disease(HVOD).Other 15 patients achieved engraftment confirmed by blood type, chromosome test and DNA polymorphism，with median times of neutrophil >0.5×109/L and platelet >20×109/L being 13（9～17）d and 16（8～26）d respectively.Six patients developed acute GVHD(4 developed gradeⅠand 2 developed gradeⅡ).Seven patients experienced local chronic GVHD.Ten patients were found to have disease-free survival(DFS), median of 45 （3～78）months.Conclusion Allo-PBSCT was an effective therapy for acute monocytic leukemia，it was safe and feasible，and long term survival was hoped for patients of this type. |
| Key words: Hematopoietic stem cell transplantation Acute monocytic leukemia Efficacy |
