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目的观察外周血造血干细胞移植(peripheral blood stem cell transplantation,PBSCT)治疗恶性血液病的临床效果。方法选择2004年7月～2010年10月恶性血液病103例,其中80例行异基因PBSCT治疗,23例行自体PBSCT治疗。异基因PBSCT采用粒细胞集落刺激因子(colony-stimulating factor,G-CSF)、自体PBSCT采用化疗联合G-CSF动员外周血造血干细胞。白血病和骨髓增生异常综合征、多发性骨髓瘤、淋巴瘤的治疗先预处理,并预防异基因PBSCT移植物抗宿主病(graft versus host disease,GVHD)的发生。结果本组均成功植入并快速重建造血,中性粒细胞恢复至≥0.5×109/L、血小板恢复至≥20×109/L的中位天数分别为19 d和21 d。随访至今,死亡21例,病死率为20.4%。发生出血性膀胱炎4例,巨细胞病毒性肺炎1例。结论 PBSCT能很快重建造血,移植相关病发生较少,病死率较低,安全可行,是治疗恶性血液病有效的手段之一。
Objective To observe the clinical effect of peripheral blood stem cell transplantation (PBSCT) in the treatment of hematologic malignancies. Methods 103 patients with hematologic malignancies were selected from July 2004 to October 2010, of which 80 received allogeneic PBSCT and 23 received autologous PBSCT. Allogeneic PBSCT using colony-stimulating factor (G-CSF), autologous PBSCT using chemotherapy combined with G-CSF mobilization of peripheral blood stem cells. Leukemia and myelodysplastic syndrome, multiple myeloma, lymphoma treatment of pretreatment and prevention of allogeneic PBSCT graft versus host disease (GVHD) of the occurrence. Results The hematopoiesis was successfully reconstructed in this group. Neutrophils recovered to ≥0.5 × 109 / L and platelets recovered to ≥20 × 109 / L for median days of 19 days and 21 days, respectively. Up to now, there were 21 deaths and the case fatality rate was 20.4%. Hemorrhagic cystitis occurred in 4 cases, cytomegalovirus pneumonia in 1 case. Conclusion PBSCT can reconstruct hematopoiesis soon, with less incidence of transplant-related diseases, lower case fatality rate and safety and feasibility, and is one of the effective measures for the treatment of hematologic malignancies.