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目的 分析总结异基因造血干细胞移植治疗急性和慢性白血病的疗效、并发症以及不良反应。方法 采用同胞异基因骨髓移植、同胞异基因外周血造血干细胞移植以及无血缘关系骨髓移植对 35例缓解期或复发难治性成人白血病进行了移植。结果 平均随访 2 6月 ,10例急性白血病有 5例仍无病存活 ,2 5例慢性粒细胞性白血病仍无病存活 2 1例 (84% )。主要并发症 :急性 GVHD11例 ,慢性 GVHD15例 ,CMV感染间质性肺炎 6例 ,其中重症感染者 3例 ,肝静脉闭塞病 (HVOD) 7例 ,严重感染败血症 9例 ,白血病复发 3例。结论 异基因造血干细胞移植是治疗成人急、慢性白血病的有效方法 ,相当部分患者可以通过移植获得治愈
Objective To summarize the curative effects, complications and adverse reactions of allogeneic hematopoietic stem cell transplantation in the treatment of acute and chronic leukemia. Methods 35 allogeneic bone marrow transplantation, sibling allogeneic peripheral blood stem cell transplantation and unrelated bone marrow transplantation were performed in 35 patients with remission-refractory or refractory adult leukemia. Results In a mean follow-up of 2 months, 5 of 10 acute leukemias still survived without disease, and 25 (84%) still had disease-free survival in 25 patients with chronic myeloid leukemia. The main complications were: 11 cases of acute GVHD, 15 cases of chronic GVHD, 6 cases of CMV infection interstitial pneumonia, 3 cases of severe infection, 7 cases of hepatic veno-occlusive disease (HVOD), 9 cases of severe sepsis and 3 cases of leukemia recurrence. Conclusion Allogeneic hematopoietic stem cell transplantation is an effective method for the treatment of acute and chronic leukemia in adults. A considerable number of patients can be cured by transplantation