中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2013年
5期
390-394
,共5页
黄文荣%李红华%金香淑%王书红%薄剑%赵瑜%靖彧%朱海燕%窦立萍
黃文榮%李紅華%金香淑%王書紅%薄劍%趙瑜%靖彧%硃海燕%竇立萍
황문영%리홍화%금향숙%왕서홍%박검%조유%정욱%주해연%두립평
治疗效果%安全%血液系统疾病%外周血干细胞移植
治療效果%安全%血液繫統疾病%外週血榦細胞移植
치료효과%안전%혈액계통질병%외주혈간세포이식
Treatment outcome%Safety%Hematologic diseases%Peripheral blood stem cell transplantation
目的 评价非去T细胞人类白细胞抗原(HLA)单倍型相合外周血造血干细胞移植治疗血液系统疾病的疗效与安全性.方法 回顾性分析2007年7月-2011年12月在解放军总医院行HLA单倍型相合外周血造血干细胞移植的病例资料.结果 49例移植受者中位年龄22(3 ～59)岁.供受者HLA配型5/10相合15例,6/10相合11例,7/10相合7例,8/10相合5例,9/10相合11例.输注的单个核细胞中位数为10.01 (7.05 ～ 25.34)×108/kg,CD34+细胞中位数为4.51 (2.01 ～11.47)×106/kg.1例复发难治型白血病患者植入失败.髓系造血重建中位时间为14(10～25)d,血小板重建中位时间为22(10～135)d.移植后中位随访时间347(7～ 1765)d.移植后100 d急性移植物抗宿主病(aGVHD)累计发生率为(61.6±7.3)％,Ⅱ～Ⅳ度aGVHD累计发生率为(28.6±6.7)％.2年慢性移植物抗宿主病(cGVHD)累计发生率为(42.6±8.5)％,广泛性cGVHD累计发生率为(22.7±7.6)％.100 d移植相关死亡累计发生率为(14.7±5.1)％,2年移植相关死亡累计发生率为(30.9±8.8)％；移植后2年累计复发率为(25.4±7.0)％.2年累计总生存率和无病生存率分别为(58.1±8.8)％和(53.9±8.4)％.结论 非去T细胞亲缘HLA单倍型相合外周血造血干细胞移植是一种有效的造血干细胞移植方式.
目的 評價非去T細胞人類白細胞抗原(HLA)單倍型相閤外週血造血榦細胞移植治療血液繫統疾病的療效與安全性.方法 迴顧性分析2007年7月-2011年12月在解放軍總醫院行HLA單倍型相閤外週血造血榦細胞移植的病例資料.結果 49例移植受者中位年齡22(3 ～59)歲.供受者HLA配型5/10相閤15例,6/10相閤11例,7/10相閤7例,8/10相閤5例,9/10相閤11例.輸註的單箇覈細胞中位數為10.01 (7.05 ～ 25.34)×108/kg,CD34+細胞中位數為4.51 (2.01 ～11.47)×106/kg.1例複髮難治型白血病患者植入失敗.髓繫造血重建中位時間為14(10～25)d,血小闆重建中位時間為22(10～135)d.移植後中位隨訪時間347(7～ 1765)d.移植後100 d急性移植物抗宿主病(aGVHD)纍計髮生率為(61.6±7.3)％,Ⅱ～Ⅳ度aGVHD纍計髮生率為(28.6±6.7)％.2年慢性移植物抗宿主病(cGVHD)纍計髮生率為(42.6±8.5)％,廣汎性cGVHD纍計髮生率為(22.7±7.6)％.100 d移植相關死亡纍計髮生率為(14.7±5.1)％,2年移植相關死亡纍計髮生率為(30.9±8.8)％；移植後2年纍計複髮率為(25.4±7.0)％.2年纍計總生存率和無病生存率分彆為(58.1±8.8)％和(53.9±8.4)％.結論 非去T細胞親緣HLA單倍型相閤外週血造血榦細胞移植是一種有效的造血榦細胞移植方式.
목적 평개비거T세포인류백세포항원(HLA)단배형상합외주혈조혈간세포이식치료혈액계통질병적료효여안전성.방법 회고성분석2007년7월-2011년12월재해방군총의원행HLA단배형상합외주혈조혈간세포이식적병례자료.결과 49례이식수자중위년령22(3 ～59)세.공수자HLA배형5/10상합15례,6/10상합11례,7/10상합7례,8/10상합5례,9/10상합11례.수주적단개핵세포중위수위10.01 (7.05 ～ 25.34)×108/kg,CD34+세포중위수위4.51 (2.01 ～11.47)×106/kg.1례복발난치형백혈병환자식입실패.수계조혈중건중위시간위14(10～25)d,혈소판중건중위시간위22(10～135)d.이식후중위수방시간347(7～ 1765)d.이식후100 d급성이식물항숙주병(aGVHD)루계발생솔위(61.6±7.3)％,Ⅱ～Ⅳ도aGVHD루계발생솔위(28.6±6.7)％.2년만성이식물항숙주병(cGVHD)루계발생솔위(42.6±8.5)％,엄범성cGVHD루계발생솔위(22.7±7.6)％.100 d이식상관사망루계발생솔위(14.7±5.1)％,2년이식상관사망루계발생솔위(30.9±8.8)％；이식후2년루계복발솔위(25.4±7.0)％.2년루계총생존솔화무병생존솔분별위(58.1±8.8)％화(53.9±8.4)％.결론 비거T세포친연HLA단배형상합외주혈조혈간세포이식시일충유효적조혈간세포이식방식.
Objective To evaluate the efficacy and safety of unmanipulated haploidentical allogeneic peripheral blood stem cells transplantation (PBSCT) on hematologic diseases.Methods Patients who underwent unmanipulated HLA-mismatched/haploidentical PBSCT from July 2007 to December 2011 were investigated retrospectively.Results Forty-nine patients with hematologic diseases underwent unmanipulated human leukocyte antigen (HLA)-mismatched/haploidentical PBSCT with myeloablative conditioning.All patients were mismatched at the allele level for HLA-A,HLA-B,HLA-Cw,HLA-DRB1 and HLA-DQ1.Fifteen patients were mismatched in 5 loci,11 patients in 4 loci,7 patients in 3 loci,5 patients in 2 loci,and 11 patients in 1 locus.The median numbers of mononuclear cells and CD34+ cells infused at transplantation were 10.01 (7.05-25.34) × 108/kg and 4.51 (2.01-11.47) × 106/kg,respectively.Patients achieved myeloid and platelet engraftment at a median of 14 (10-25) days and 22(10-135) days,respectively.The cumulative incidence of acute graft versus host disease (aGVHD) on day 100 was (61.6 ± 7.3)％,and the 2-year cumulative incidence of chronic graft versus host disease (cGVHD) was (42.6± 8.5)％.One hundred-day transplantation related mortality (TRM) rate and 2-year cumulative TRM rate were (14.7 ± 5.1) ％ and (30.9 ± 8.8) ％,respectively.The 2-year cumulative incidence estimate of relapse was (25.4 ± 7.0) ％.The 2-year cumulative overall survival rate was (58.1 ±8.8) ％ and 2-year disease-free survival rate was (53.9 ± 8.4) ％ with an 11.5-months median follow-up.Conclusion Unmanipulated PBSCT is a promising protocol for patients with hematologic diseases in HLA-mismatched/haploidentical transplant settings.
