供者淋巴细胞输注诱导GVL效应治疗白血病并发肝脏GVHD
造血干细胞移植,,造血干细胞移植；非清髓性；供者淋巴细胞输注；急性白血病；移植物抗白血病效应；移植物抗宿主病,1病例资料,2治疗方法,3结果,4讨论,【参考文献】
【摘要】 目的 探讨非清髓性造血干细胞移植后供者淋巴细胞输注治疗急性白血病的疗效。方法 对1例未分类的急性白血病，进行非清髓性的造血干细胞移植。预处理方案：马利兰8mg/kg、环磷酰胺120mg/kg、抗胸腺细胞球蛋白(ATG)25mg/kg。移植物抗宿主病(GVHD)预防：环孢素A联合短程甲氨喋呤。在获得造血干细胞植入，形成混合性嵌合体(MC)后，于+53天、+98天、+125天、+152天、+182天，行G-CSF动员后的供者淋巴细胞输注(DLI)。结果 移植早期形成MC状态，达到血液学部分缓解，无急性GVHD发生。+102天血型转变为供者型；第5次DLI后，获得血液学完全缓解及供者完全嵌合体，并发肝功能损伤为表现的慢性GVHD。结论 非清髓性造血干细胞移植治疗急性白血病后行DLI，可获得供者完全嵌合体及血液学完全缓解，但需注意DLI后的慢性GVHD。【关键词】 造血干细胞移植；非清髓性；供者淋巴细胞输注；急性白血病；移植物抗白血病效应；移植物抗宿主病
Graft-versus-host disease of liver complicated by donor lymphocyte infusion for inducing graft-versus-leukemia effect for acute leukemia
LI Xin-yan，MAO Ping，LI Qing-shan,et al.
Department of Hematology,The First Municipal Peoples'Hospital of Guangzhou,Guangzhou 510180,China
【Abstract】 Objective To explore clinical curative effect of donor lymphocyte infusion followed by non-myeloablative haemotopoietic stem cell transplantation for acute leukemia.Methods One patient with unclssified acute leukemia was performed allogeneic haematopoietic stem cell transplantation with non-myeloablative conditioning regimen consisting of anti-themocyte globulin(25mg/kg),busulfan(8mg/kg) and CTX. (120mg/kg).Donor lymphocyte infusion after mobilized by G-CSF were performed after donor stem cell engraftment with mixed chimerism at day of 53,98,125d,152 and 182 post transplantation. GVHD prophylaxis consisted of short course methotrexate and cyclosporine.Results The patient achieved haematologic partial remission with mixed chimeria at early stage,without acute GVHD.The patient's blood group transmitted donor's type at 102 days post transplantation. After fifth DLI,the patient achieved haematologic complete remission and full donor chimerism complicated with chronic GVHD presentating liver funcation damage.Conclusion DLI followed by non-myeloablative stem cell transplantation can achieve hamotologic remission and full donor chimerism ,but chronic GVHD must be played attention to. ......
您现在查看是摘要页，全文长 7901 字符。