【摘要】 目的:观察低温冰箱转液氮阶梯降温冷冻保存的自体外周血造血干细胞移植治疗恶性血液病的效果,并分析造血干细胞移植后患者生存情况。方法:使用3%羟乙基淀粉、4%白蛋白和5%二甲亚砜(DMSO)组成的冷冻保护剂保护自体造血干细胞,后置于-80℃低温冰箱,再置-196℃液氮罐长期储存,然后用于自体移植。2002年1月至2016年12月98例恶性血液病患者,其中包括急性淋巴细胞白血病10例,非急性髓系白血病24例,多发性骨髓瘤11例,恶性淋巴瘤53例的自体移植。对患者造血恢复时间、总生存率(overall survival,OS)、无进展生存率(progression-free survival,PFS)进行了统计分析。结果:除1例因颅内出血死亡未成功植入外,余97例患者均获得造血重建。中性粒细胞计数≥0.5×10~9/L所需时间平均为9.24±1.89 d,连续3 d不输血小板且血小板≥20×10~9/L所需时间平均为11.04±1.84 d。中位生存时间为47.6 (1-80)个月。1、3和5年总生存率分别为(97.2±1.9)%、(84.2±4.6)%和(77.8±5.6)%。3和5年PFS分别为(74.4±5.1)%和(61.2±6.2)%。结论:通过低温冰箱转液氮阶梯降温法冷冻保存造血干细胞自体移植,可以达到和传统的程序降温冷冻保存法一样的临床移植效果,且移植后并发症发生率无增多。更多还原

【Abstract】 Objective: To investigate the efficacy of hematopoietic stem cells cryopreserved by ladder-style freezing from low temperature refrigerator to liquid nitrogen in treatment of hematological malignancies, and to analyze the survival condition of patients after hematopoietic stem cell transplantation. Methods: The coyoprotectant formed by 3% hydroxyethyl starch, 4% albumin and 5% dimethyl sulfoxide(DMSO) was need for cryopreservation of hematopoietic stem cells,which were first placed in-80 ℃ low temperature refrigerator and then were stored in-196 ℃ liquid nitrogen tank.98 cases of hemafologic malignancies(io cases of ALL, 24 cases of AML, L-cases of MM and 53 case of malignant lymphoma) were selected from January 2002 to December 2016, and recived transplantatin auto-hematopoiehc stem cells cryopresorved by above-mentined method. The overall survival rate(OS), progression-free survival(PFS) were analyzed statistically. Results: One case failed in implantation due to intracranial hemorrhage and the other 97 cases all succeeded in hematopoietic reconstitution. The average time needed for neutrophil count ≥ 0.5 × 1~09/L was 9.24 ± 1.89 d,and the average time needed for blood platelet ≥ 20 × 109/L without platelet transfusion for 3 days was 11.04 ± 1.84 d. The median survival time was 47.6 months(1-80 months). The 3 and 5 year OS rates were(97.2 ± 1.9) %,(84.2 ± 4.6) % and(77.8 ± 5.6)%, respectively. 3-and 5-year PFS of patients were(74.4 ± 5.1)% and(61.2 ± 6.2)%. Conclusion: ladder-style freezing from low temperature refrigerator to liquid nitrogen can reach the same clinical transplantation effect with traditional programmed cooling freezing method in autologous hematopoietic stem cells transplantation. moreover the incidence of complications after transpeantatim does not show increase.更多还原