CAJ | 학술논문

探讨供者淋巴细胞输注(DLI)联合化疗治疗异基因造血干细胞移植( Allo - HSCT)后白血病复发的疗效、并发症及护理方法.对Allo - HSCT后白血病复发的6例患者予分次逐渐提高单次剂量方案(EDR)的DLI联合化疗治疗,观察输注后白血病血液学完全缓解(CR)率、无病生存(DFS)率、移植物抗宿主病(GVHD)和骨髓抑制发生率、输注时尿常规,患者的反应情况.输注过程仅有2例轻微发热,6例均获得血液学CR,CR率100％,STR - PCR测定证实恢复为供者基因型；随访70 d至14个月,2例DLI后50 d发生慢性GVHD,发生率33.2％,无1例发生急性GVHD,2例全血细胞减少骨髓抑制,发生率33.2％；5例DFS,1例于DLI后70 d死于CMV性间质性肺炎.随访至今,5例DFS患者血象和骨髓象一直正常.EDR、DLI联合化疗治疗Allo - HSCT后白血病复发疗效显著、副作用小、应用安全.
탐토공자림파세포수주(DLI)연합화료치료이기인조혈간세포이식( Allo - HSCT)후백혈병복발적료효、병발증급호리방법.대Allo - HSCT후백혈병복발적6례환자여분차축점제고단차제량방안(EDR)적DLI연합화료치료,관찰수주후백혈병혈액학완전완해(CR)솔、무병생존(DFS)솔、이식물항숙주병(GVHD)화골수억제발생솔、수주시뇨상규,환자적반응정황.수주과정부유2례경미발열,6례균획득혈액학CR,CR솔100％,STR - PCR측정증실회복위공자기인형；수방70 d지14개월,2례DLI후50 d발생만성GVHD,발생솔33.2％,무1례발생급성GVHD,2례전혈세포감소골수억제,발생솔33.2％；5례DFS,1례우DLI후70 d사우CMV성간질성폐염.수방지금,5례DFS환자혈상화골수상일직정상.EDR、DLI연합화료치료Allo - HSCT후백혈병복발료효현저、부작용소、응용안전.
To observe effects and complications of donor lymphocyte infusions (DLI) combined with chemotherapy in the treatment of relapsed leukemia after allogeneic hematopoietic stem cell transplantation for improving nursing technology.Six patients received DLI combination chemotherapy in the treatment of relapsed leukemia after allogeneic hematopoietic stem cell transplantation.After treatment,the hematological complete remission ( CR ) rate,disease free surviva (DFS) rate,graft -versus -host disease ( GVHD ) and bone marrow suppression incidence were observed.Two cases had low fever during infusion.After treatment,all cases got blood CR,and the CR rate was 100％.Determination of STR - PCR confirmed the recovery of donor genotype.In the 70days to 14 months follow -up,2 cases got chronic GVHD after 50 days,and the incidence rate was 33.2％.No case got acute GVHD.2 patients suffered with pancytopenia that caused by bone marrow suppression,and the occurrence rate was 33.2％.5 patients got disease free survival ( DFS ).1 cases died of CMV interstitial pneumonia after 70 days.5 patients had normal hemogram and myelogram from then on.DLI combined with chemotherapy in the treatment of relapsed leukemia after allogeneic hematopoietic stem cell transplantation is safe and effective.