癌光啉体外净化骨髓中残留白血病变后行自体骨髓移植治疗白血病

Autologous bone marrow transplantation with purging of residual leukemic cells in bone marrow by PSD 007 in vitro

  • 摘要: 目的: 为减少白血病患者自体骨髓移植后白血病复发率和提高长期无病存活率。方法: 采用缓解期急性非淋巴细胞白血病患者的骨髓细胞在体外经处理后用癌光啉(浓度为10μg/ml)加光照净化,待患者完成预处理后回输给自身。结果: 10例急性髓细胞白血病患者接受了本净化方法后移植治疗。净化后输入有核细胞中位数1.30(0.7~2.4 5)× 108/kg,CD34+细胞中位数2.39(0.74~4.06)× 106/kg,CFU-GM中位数1.4 4(0.32~4.65)× 104/kg。10例中9例造血功能重建,WBC升到>1.0× 109/L中位数时间20(15~43) d,>2.0×109/L中位数时间30(21~55) d,BPC>5 0× 109/L中位数时间46(25~62) d。经中位26个(20~64)月随访,有6例仍无病存活;3例复发,其中2例复发后失去随访;1例嗜碱细胞性白血病经化疗再次取得缓解,至今CR2后又无复发存活14个月;1例死于与移植相关并发症。结论:初步结果表明,用癌光啉加光照净化自体骨髓中残留白血病细胞后行自体骨髓移植治疗白血病是一种安全而有潜力的方法。

     

    Abstract: Objective: To find a new way to decrease the relapse rate and to prolong the disease free survival (DFS) in patients with leukemia after autologous bone marrow transplantation (ABMT). Methods: Bone marrow cells of patients with acute myeloid leukemia (AML) in complete remission (CR) were purged by exposure to light after being treated by a kind of hematoporphyrin derivative,PSD-007(10μg/ml in concentration).Then these cells were reinfused to the patients after treated by conditioning regiments. Results: Ten patients with AML received this purging process in their treatment of ABMT.The median numbers of mononuclear cells,CD34+ cells and CFU-GM infused after purging were 1.3(0.7~2.45) ×108/kg,2.39(0.74~4.06) ×106/kg and 1.44(0.32~4.65) ×104/kg,respectively.Nine of the10 patients obtained hematopoiesis reconstitution.It took median time of20(15~43) days and 30(21~55) days for WBC to reach >1.0×109/L and 20×109/L,and46(25~62) days for BPC recover to 50×109/L.The mean follow-up per-i od was 26months (range 20~64).Six patients are still achieve DFS,the other three patients relapsed,two of which were out of contact and one with acute basophilic leukemia obtained CR2 after further chemotherapy posttransplantation, and remains in CR2 for 14months.One patient died from transplant related complications. Conclusion: Our preliminary data suggest that autologous bone marrow transplantation with purging by PSD-007 in vitro is a safe and well theraputic option for patients with AML.

     

/

返回文章
返回