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目的 评价亲缘异基因骨髓移植 (allo -BMT)治疗慢性髓系白血病 (CML)的临床疗效。 方法2000年9月至2002年6月 ,对11例CML慢性期患者进行HLA相合亲缘allo-BMT。预处理方案 :马利兰16mg/kg+环磷酰胺120mg/kg。急性移植物抗宿主病 (GVHD)预防 :霉酚酸酯、环孢素A加短程甲氨喋呤。结果 11例患者均获供髓植入 ,中性粒细胞数大于0.5×109/L中位时间15(11～20)d ,血小板数大于20×109/L中位时间20(10～35)d。发生Ⅱ～Ⅳ度急性GVHD2例 (18.2%) ,慢性GVHD4例 (36.4 %)。移植相关死亡2例(18.2%) ,复发1例(9.1 %)。中位随访时间20(5～31)月 ,Kaplan-Meier生存曲线的2年无病生存率为 (70.7±14.3) %。 结论亲缘allo-BMT是治疗CML的有效方法 ,霉酚酸酯可安全而有效地应用于急性GVHD的预防。
Objective To evaluate the clinical efficacy of allogeneic bone marrow transplantation (allo-BMT) in the treatment of chronic myelogenous leukemia (CML). Methods From September 2000 to June 2002, HLA-matched allo-BMT was performed in 11 patients with chronic CML. Pretreatment program: Maryland 16mg / kg + cyclophosphamide 120mg / kg. Acute graft versus host disease (GVHD) prophylaxis: mycophenolate mofetil, cyclosporin A plus short-course methotrexate. Results All the 11 patients were given with marrow for transplantation, the median neutrophil count was more than 0.5 × 109 / L, the median time was 15 (11 ~ 20) d, the platelet count was more than 20 × 109 / L, the median time was 20 (10 ~ 35) d. Two cases of acute GVHD Ⅱ ~ Ⅳ degrees (18.2%), 4 cases of chronic GVHD (36.4%). Two transplant-related deaths (18.2%) and one recurrence (9.1%) occurred. The 2-year disease-free survival of the Kaplan-Meier survival curve was (70.7 ± 14.3)% at a median follow-up of 20 months (range 5 to 31). Conclusion Allo-BMT is an effective treatment for CML. Mycophenolate mofetil can be safely and effectively used in the prevention of acute GVHD.