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With total body irradiation with or without total body irradiation pre-hematopoietic stem cell transplantation for hematologic malignancies


The first 3,2 days. 1 patient (ANIL, line AIIO-PBSCT) on the basis of the MAC plus Fludarabine (30mg / m · d, 9 before transplantation to 4 days). 1.5 major complications and prevention of adverse reactions to prevent hemorrhagic cystitis (HC) with high-dose infusion, urine and forced alkaline diuresis, intravenous infusion of sodium Metz,[link widoczny dla zalogowanych], ganciclovir or acyclovir to prevent giant infected cells to prevent interstitial pneumonia (IP), intravenous dextran Salviae prevention of hepatic veno-occlusive disease (VOD), oral phenytoin sodium to prevent epileptic seizures; 6 cases of allogeneic peripheral blood stem cell transplantation in patients with cyclosporine A (CsA) plus short methotrexate prevent graft-versus-host disease (GVHD). Ondansetron or metoclopramide hydrochloride anthracene Dancy ketone or prevent gastrointestinal side effects, to maintain water and electrolyte balance. 1.6 Statistical analysis using t test. 2 Results 2.1 hematopoietic function recovery were 25 cases of hematopoietic reconstruction,[link widoczny dla zalogowanych], including TBI and non-TBI conditioning regimen WBC ≥ 1.0 × 10. / I, platelets ≥ 20 × 10. I days are stem cell transplantation after 8 to 19 (mean 11.5) days after stem cell transplantation 9 to 29 (mean 15) days after stem cell transplantation 7 to 19 (mean 11) days after stem cell transplantation 8 28 (mean 14) days. 2.2 The main side effects and complications of different degrees in all cases of gastrointestinal reactions, without any V () D, IP, HC, epileptic convulsions. 6 patients with mild cardiac toxicity. 6 cases of allogeneic peripheral blood stem cell transplantation in 3 cases of patients with varying degrees of GVHD, with or without TBI group was 50. But the TBI group with the incidence of oral mucositis was significantly higher than non-TBI group, the difference was statistically significant (P 0.05) (Table 1). Table 1 TBI conditioning regimen with or without major side effects and efficacy of three pre-program discussion of the success of hematopoietic stem cell transplantation in one of the main factors. Pretreatment of patients with the aim of maximizing the body to kill tumor cells,[link widoczny dla zalogowanych], inhibition of immune function, for the bone marrow hematopoietic stem cell transplantation space. The traditional program of TBI plus CTX is effective, but relevant to the needs of radiotherapy equipment and personnel, and more recent adverse reaction. BMT reported in the literature typically use high-dose alkylating agent pretreatment and (or) radiotherapy on gonadal damage is more significant in patients receiving pre-TBI, transplantation often irreversible gonadal damage, chemotherapy induced gonadal injury pretreatment often reversible, can be self-healing. BuCy conditioning regimen and immunosuppressive effects of anti-leukemia reliable,[link widoczny dla zalogowanych], and the classic effect of TBI plus CY preparative regimen is comparable to the hematopoietic stem cell transplantation was pretreated with combination chemotherapy provides a new way of thinking. MAC pretreatment program from a variety of myeloid leukemia in the short-term and long-term efficacy is satisfactory. The group of non-TBI conditioning regimen mainly MAC and BuCy,[link widoczny dla zalogowanych], compared with patients with TBI, hematopoietic reconstitution after transplantation, reconstruction time, GVHD, the recent effect of the two groups was no significant difference between the two groups of cases (clinical follow-up ≥ June) did not appear VOD, IP, HC, and preventive measures may be appropriate, or sample size less relevant, but the adverse reactions oral mucosa TBI group were significantly higher than that of not containing TBI pretreatment group. From this group of cases the efficacy, toxicity, hematopoietic reconstruction, data indicate that non-TBI conditioning regimen is also applicable to stem cell transplantation in patients with hematologic malignancies, it has relatively few adverse reactions, without radiotherapy equipment, is more suitable basic hospital and so on. But its long-term effect remains to be seen, to find a more reasonable and effective dose conditioning regimen with low toxicity to be further studied. [
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