【摘要】 目的探讨应用人类白细胞抗原(HLA)相合同胞供者造血干细胞移植(HSCT)治疗T细胞急性淋巴细胞白血病(T-ALL)。方法总结北京大学血液病研究所于2004年1月至2009年2月进行的9例HLA相合同胞HSCT治疗T-ALL。干细胞来源:2例为外周血干细胞,7例为骨髓及外周血干细胞。预处理方案:6例为改良马利兰(BU)/环磷酰胺(CY),3例为环磷酰胺/全身照射(TBI)。预防急性移植物抗宿主病(GVHD)采用环孢霉素A、短疗程氨甲喋呤及霉酚酸酯(骁悉)。结果采集单个核细胞数中位6.97×108/kg[(6.34～9.20)×108/kg],中位+14d(+12～+19d)中性粒细胞(ANC)大于0.5×109/L。中位+13d(+1～+17d)血小板大于20.0×109/L。发生急性Ⅱ度GVHD1例(11%),发生慢性GVHD4例(44%),皆为广泛性,其中2例为供者淋巴细胞输注后。中位随访时间581d(199～1936d),5例患者无病生存。结论异基因HSCT可以作为治疗成人T-ALL的有效手段。更多还原

【Abstract】 Objective Explore the feasibility of HLA matched hemopietic stem cell transplants for the treatment of T cell acute lymphocytic leukemia.Methods Between January 2004 and February 2009,nine patients with T cell acute lymphocytic leukemia(ALL)received hemopietic stem cell transplants(HSCT)with HLA matched sibling donors.Stem cell sources were G-CSF mobilized bone marrow combined with peripheral blood(n=7)or G-CSF mobilized peripheral blood(n=2).Six patients were conditioned with busulfan(BU)12 mg/kg and cyclophosphamide(CY)3.6 g/m2 and three patients were conditioned with TBI 770 Gy and cyclophosphamide(CY)3.6 g/m2.Graft versus host disease(GVHD)prophylaxis regimen consisted of cyclosporin-A(CSA),methotrexate(MTX)and mycophenolate mofetil(MMF).Results Patients received a median of 6.97×108/kg(6.34×108～9.20×108/kg)mononuclear cells(MNC).The median time of ANC>0.5×109/L was day 14(12～19),and BPC>20.0×109/L was day 13(1～17).All the patients got engraftment successfully and attained CR.Acute GVHD gradeⅡoccurred in 1(11.1%)patients,no acute Ⅲ～Ⅳ GVHD occurred and extensive chronic GVHD did in 4(44.4%)patients.Five patients were alive and well after 199～1936 days follow-up.Conclusion Allogeneic stem cell transplant appears to be effective for the treatment of T cell acute lymphocytic leukemia.更多还原