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背景与目的:常规化疗治疗难治性白血病的缓解率低于50%,增加化疗强度常因严重并发症导致患者死亡,我们既往的研究表明单倍体淋巴细胞在体外具有较强杀伤白血病细胞效应。本研究旨在观察常规化疗联合经7.5Gyγ射线照射的单倍体淋巴细胞输注治疗难治性白血病的效果和不良反应。方法:16例难治性白血病患者在化疗后,当白细胞降至最低时平均输注1×108/kg(0.8～1.2×108/kg)经7.5Gyγ射线照射的单倍体淋巴细胞,观察难治性白血病的缓解率和单倍体淋巴细胞输注的不良反应。结果:13例难治性急性非淋巴细胞白血病经该治疗后,11例达完全缓解,2例达部分缓解。3例难治性急性淋巴细胞白血病患者,2例完全缓解,1例无效。全组16例患者的总缓解率为81.2%。单倍体淋巴细胞输注后患者感觉良好,无一例长时间骨髓抑制,无输注相关的移植物抗宿主病。结论:化疗联合单倍体淋巴细胞输注可以提高难治性白血病的缓解率,减少化疗引起的并发症。
BACKGROUND & OBJECTIVE: The remission rate of conventional chemotherapy in the treatment of refractory leukemia is less than 50%. Increasing the intensity of chemotherapy often leads to the death of patients due to serious complications. Our previous studies have shown that haploid lymphocytes have strong anti-leukemic cell effect in vitro . The aim of this study was to investigate the efficacy and adverse reactions of conventional chemotherapy combined with haploidentical lymphocyte infusion irradiated with 7.5Gy gamma rays in patients with refractory leukemia. METHODS: Twenty-six patients with refractory leukemia received an average infusion of 1x108 / kg (0.8-1.2x108 / kg) of haploid lymphocytes irradiated with 7.5Gy gamma-rays after chemotherapy, with minimal leukocyte infiltration Remission rate of the treatment of leukemia and haploidentical lymphocyte infusion of adverse reactions. Results: Thirteen cases of refractory acute non-lymphocytic leukemia achieved complete remission in 11 cases and partial remission in 2 cases. Three patients with refractory acute lymphoblastic leukemia were completely relieved in 2 patients and ineffective in 1 patient. The overall response rate of 16 patients was 81.2%. Patients did not feel prolonged after infusion of haploid lymphocytes, with no long-term bone marrow suppression and no infusion-related graft-versus-host disease. Conclusion: Chemotherapy combined with haploidentical lymphocyte infusion can improve the remission rate of refractory leukemia and reduce the complications caused by chemotherapy.