【摘要】 目的比较无血缘关系供者外周血干细胞移植和骨髓移植在造血重建、T 细胞重建、感染、移植物抗宿主病(GVHD)及疗效等的差异。方法 53例白血病患者中,21例接受无血缘关系供者外周血干细胞移植(PBSCT 组),32例接受无血缘关系供者骨髓移植(BMT 组)。统计分析二者移植后白细胞和血小板重建时间、T 细胞重建、感染率、GVHD、白血病复发、无病生存(DFS)情况。结果PBSCT 组和 BMT 组移植后白细胞重建时间分别为(12.43±3.67)天和(16.16±2.99)天(P<0.01),血小板重建时间分别为(14.67±6.19)天和(21.23±8.25)天(P<0.01)。PBSCT 组和 BMT 组移植后1,3,6,9及12个月的 T 细胞重建差异无统计学意义。PBSCT 组和 BMT 组移植后早期感染率分别为42.86%和53.13%(P>0.05)。PBSCT 组与 BMT 组急性 GVHD 的发生率分别为61.90% 和71.885(P>0.05);在可统计的患者中,慢性 GVHD 的发生率在 PBSCT 组和 BMT 组分别为47.06%和43.48%(P>0.05)。PBSCT 组与 BMT 组移植后分别有4例和2例复发,二者复发率差异无统计学意义(P>0.05);PBSCT 组与 BMT 组移植后2年 DFS 率分别为(50.14±12.00)% 和(59.81±8.99)%,二者差异也无统计学意义(P>0.05)。结论无血缘关系供者 PBSCT 后的造血重建比BMT,但二者移植后 T 细胞重建、感染发生率、GVHD 及 DFS 的差异均无统计学意义。更多还原

【Abstract】 Objective To compare the hemopoietic reconstitution,immune reconstitution,infection, incidence of graft-versus-host disease(GVHD)and clinical outcome between unrelated donor peripheral blood stem cell(PBSC)transplantation and bone marrow(BM)transplantation for leukemias.Methods The clinical results of 21 leukemia patients receiving G-CSF mobilized PBSC graft from unrelated donors were com- pared with that of 32 patients receiving unrelated BM transplants.Results Compared with BM grafts,the PBSC graft contained significantly more nucleated cells(P=0.000),and resulted in a significantly shorter time-to-neutrophil(12.43±3.67 vs 16.16±2.99 days)and platelet engraftment(14.67±6.19 vs 21.23± 8.25 days),(P=0.000 and 0.003,respectively).T cell reconstitution between the two groups differed lit- tle after transplantation.The incidences of early-stage infection(42.86% vs 53.13%),the probabilities of acute graft-versus-host disease(aGVHD)(61.90% vs 71.88%),the grades Ⅲ to Ⅳ aGVHD(23.81% vs 15.63%),the chronic GVHD(47.06% vs 43.48%)and the probabilities of relapse(6.90% vs 12.50%) between PBSC and BM groups all has no statistical significance(NS).The 2-year disease free survival (DFS)rates of the two groups were(50.14±12.00)% and(59.81±8.99)%,respectively also have no NS.Conclusion G-CSF-mobilized unrelated donor PBSCs engraft more rapidly in the recipients as compared with conventional BM grafts.The T cell reconstitution,the incidence of infection,the incidence and severity of aGVHD and cGVHD,and the 2-year DFS rates between the two groups all have no significant differences.更多还原