异基因外周血和骨髓干细胞联合移植治疗白血病的初步研究

 目的 探讨异基因造血干细胞移植治疗白血病的新方法。方法 23例白血病患者，HLA 配型全相合9例，1～3个位点不相合14例，采用粒细胞集落刺激因子（G-CSF）动员的骨髓和外周血干细胞联合移植，采用环孢素A（CsA）和霉酚酸酯（MMF）及短程甲氨蝶呤（MTX）方案预防移植物抗宿主病（GVHD）。结果 1例植入失败，22例完全植入，HLA全相合受者未发生急性GVHD，13例HLA不全相合受者中Ⅱ～ Ⅳ度急性GVHD发生率46.2 %。20例可评估的患者中，慢性 GVHD 13例，广泛型5例，累积发生率65 %。随访6至32个月，预期一年生存率86.6 %。结论 骨髓和外周血联合移植对HLA配型全相合和部分相合患者是安全、有效的移植方法。

The clinical investigation of allogenic peripheral blood hematopoietic stem cells with bone marrow transplantation for leukemic patients

Objective To investigate the new methods of allogenic peripheral blood hematopoietic stem cells with bone marrow transplantation for leukemic patients. Methods 23 patients, 9 patients were in HLA matched and 14 patients were in HLA1 to 3 loci mismatched. After conditioning, patients received GSF primed bone marrow with peripheral blood stem cells transplantation, graft-versus-host disease (GVHD) pro－phylaxis consisted of cyclosporine A, mycophenolate mofetil, and short course methotrexate. Results Engraft－ment failed in one patient. 22 patients achieved full engraftment. The incidence of grades Ⅱ~ Ⅳacute GVHD was zero in HLA matched patients and was 46.2 % in HLA mismatched patients, 13 patients developed chronic GVHD among 20 evaluable patients, cumulative incidence of cGVHD was 65 %, extensive type exist－ed in 5 patients. follow-up lasted 6~32 months, 1 year probabilities of disease-free survival was 86.6 %. Conclusion CSF primed bone marrow with peripheral blood stem cells transplantation is feasible and safe in HLA matched and mismatched transplantation for leukemic patients.