CAJ | 학술논문

目的：探讨异基因外周血干细胞移植(allo-PBS CT)的造血重建，移植物抗宿主病(GVHD)的发生情况及其疗效。方法：对我院13例allo-PBSCT患者的临床资料进行回顾性分析。供者均系患者的同胞兄弟姐妹，12例H LA完全相合，1例HLA半相合。以G-CSF为外周血干细胞动员剂，分离单个核细胞(MNC)；采用环孢菌素A和短程氨甲喋呤或甲基强的松龙预防GVHD；BU-CY2方案预处理。结果：中性粒细胞＞0.5×109/L和血小板计数＞20×109/L的中位时间分别为13 d和12 d。HLA完全相合的12例中4例发生急性GVHD，其中Ⅰ-Ⅱ度3例，Ⅳ度1例，另1例HLA 半相合发生Ⅳ度急性GVHD，2例因Ⅳ度急性GVHD死亡。随访450～810 d，3 例复发，6例发生慢性GVHD。结论：Allo-PBSCT与allo-BMT相比，造血重建迅速，急性GVHD发生率与allo-BMT相似，慢性GVHD发生率则较高。
목적：탐토이기인외주혈간세포이식(allo-PBS CT)적조혈중건，이식물항숙주병(GVHD)적발생정황급기료효。방법：대아원13례allo-PBSCT환자적림상자료진행회고성분석。공자균계환자적동포형제저매，12례H LA완전상합，1례HLA반상합。이G-CSF위외주혈간세포동원제，분리단개핵세포(MNC)；채용배포균소A화단정안갑첩령혹갑기강적송룡예방GVHD；BU-CY2방안예처리。결과：중성립세포＞0.5×109/L화혈소판계수＞20×109/L적중위시간분별위13 d화12 d。HLA완전상합적12례중4례발생급성GVHD，기중Ⅰ-Ⅱ도3례，Ⅳ도1례，령1례HLA 반상합발생Ⅳ도급성GVHD，2례인Ⅳ도급성GVHD사망。수방450～810 d，3 례복발，6례발생만성GVHD。결론：Allo-PBSCT여allo-BMT상비，조혈중건신속，급성GVHD발생솔여allo-BMT상사，만성GVHD발생솔칙교고。
Objective:To explore the hematopoietic recon stitution,the incidence of GVHD and the efficacy of allogeneic peripheral blood stem cell transplantation (allo-PBSCT).Methods:The data of 13 leuke mia patients undergoing allo-PBSCT were retrospectively analyzed, including 12 patients receiving peripheral blood stem cell(PBSC) from HLA-match ed sibling donors,and the remaining one from haploidentical related donor.The BU -CY2 was used as conditioning regimen.Cyclosporine A and either methotrexate or methylprednisolone were administered to prevent acute GVHD.PBSC was mobilized w ith G-CSF.Results:All patients were grafted with ANC＞0.5×109/L at a median of 13 days and BPC＞20×109/L at a median of 12 days.Acute GVHD oc curred in 4 of 12 patients receiving PBSC from HLA-matched sibling donors,one r eceiving PBSC from haploidentical related donor developed grade Ⅳ acute GVHD.Ch ronic GVHD occurred in 6 patients.Two patients died of grade Ⅳ acute GVHD and 3 died of relapse.Conclusion:Allo-PBSCT can repidly reconstitute he matopoiesis,and the incidence of acute GVHD was comparable with that in allo-BM T,but the incidence of chronic GVHD was increased by allo-PBSCT as compared wit h allo-BMT.