摘要
目的观察造血干细胞移植治疗儿童血液肿瘤及其他难治性血液病的临床疗效。方法自2007年4月至2009年12月,我们共对53例血液病患儿实施了造血干细胞移植治疗,其中自体移植15例,异基因移植38例,观察其临床疗效和并发症。结果 15例患者行自体外周血造血干细胞移植后造血功能均能顺利重建,无严重并发症发生。异基因移植患儿除1例发生颅内出血早期死亡外,其余均顺利达到造血重建,但其中急性移植物抗宿主病发生率为18.4%,慢性移植物抗宿主病发生率2.6%;15例患儿于移植后0～24个月分别死于颅内出血、感染和疾病复发或进展;移植后6个月至2年存活率65%。结论造血干细胞移植是治疗儿童血液肿瘤及其他难治性血液病的有效方法,可明显改善预后;临床可根据患者原发疾病诊断、供者情况及家庭经济条件选择移植方式。
Objective To evaluate the therapeutic effect of hematopoietic stem cell transplantation for children＇s hematologic malignancies and refractory hematological diseases.MethodsA total of 53 children with hematologic malignancies and refractory hematological diseases were subjected in hematopoietic stem cell transplantation（allogenetic in 38 patients,autologous in 15 patients）from April 2007 to December 2009.There were 14 cases of acute myeloid leukemia（AML）,12 cases of acute lymphoblastic leukemia（ALL）,3 cases of acute mixed lineage leukemia（AMLL）,4 cases of chronic myeloid leukemia（CML）,6 cases of non-Hodgkin＇s lymphoma（NHL）,4 cases of NHL-ALL,4 cases of β-thalassanemia,3 cases of Idiopathic thrombocytopenic purpura（ITP）,1 cases of severe aplastic anemia（SAA）,1 case of myelodysplastic syndrome（MDS-RAEB）and 1 case of Langerhans cell histiocytosis.Chemotherapy of 2 to 3 cycles was performed on refractory hematological diseases before transplantation.The therapeutic effect,complication and total survival rate were observed,respectively.ResultsHematopoietic reconstitution was quickly obtained after auto-logous hematopoietic stem cell transplantation（HSCT）in 15 patients and no severe complication was seen.But after allo-HSCT,the incidence rate of acute and chronic GVHD was 18.4% and 2.6%.There were 15 cases died of GVHD,infection,disease relapse or development in 0 to 24 months,and 65% in this group were disease-free survival（DFS）from 6 to 24 months.ConclusionHematopoietic stem cell transplantation is effective for the treatment of children＇s hematologic malignancies and refractory hematological diseases,and improves their prognosis.And it is strongly suggested to select suitable mode of transplantation on account of diagnosis,age,physical status,economy of patient and the condition of donor.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2010年第20期2228-2231,共4页
Journal of Third Military Medical University
基金
重庆市重点学科建设基金(CSTC2009BA5011)~~
关键词
儿童血液病
造血干细胞移植
自体
异基因
children＇s refractory hematologic diseases
children＇s hematologic malignancies
hematopoietic stem cell transplantation
autologous
allogenetic
