中文摘要：

目的评估并比较异基因造血干细胞移植清髓方案治疗成人急性淋巴细胞白血病（ALL）的疗效及安全性。方法异基因造血干细胞移植治疗37例成人急性淋巴细胞白血病患者：其中17例行非血缘脐血移植（UCBT）患者中位年龄25（14~37）岁、中位体质量55（31~84）kg、男性占82%,UCBT组中高危难治患者共15例（88%）,HLA不全相合移植占94%。20例行同胞异基因外周血干细胞移植（sPB/BMT）患者中位年龄23.5（14~48）岁、中位体质量61（44~83）kg、男性占55%,其中高危难治患者共12（60%）例,HLA不全相合移植占10%。结果 UCBT组中位随访时间9（1.3~58）个月,88%的患者使用以放疗为主的清髓性预处理方案,输入脐血有核细胞数（TNC）为3.55（1.85~6.7）×107/kg,CD34＋细胞为2.77（0.935~5.24）×105/kg;sPB/BMT组中位随访时间10.75（2~60）个月,86%的患儿使用以放疗为主的清髓性预处理方案,输入TNC为5.17（3.37~8.23）×108/kg,CD34＋细胞为3.66（2.12~7.04）×106/kg。UCBT组17例中植入16例,其中髓外复发1例,骨髓复发1例。共8例（50%）出现aGVHD,其中Ⅱ~ⅣaGVHD共2例（12.5%）,2年累计总生存（OS）为（68±12.2）%;sPB/BMT组20例患儿全部植入,髓外复发2例,骨髓复发3例。共8例（40%）出现aGVHD,其中Ⅱ~ⅣaGVHD为5/20（25%）,2年累计总生存（OS）为（46.9±12.7）%。结论异基因造血干细胞移植是治疗成人急性淋巴细胞白血病的有效方法,UCBT后aGVHD发生率高但程度轻。UCBT后原发病复发率低于sPB/BMT组,且长期生存高于sPB/BMT组,UCBT应用于具有预后不良因素的成人急性淋巴细胞白血病治疗安全有效。

英文摘要：

Objective To evaluate the efficacy and safety in adult acute lymphoblastic leukemia undergoing unrelated cord blood transplants（UCBT）and sibling hematopoietic cell transplantation（SHCT）.Methods Retrospective analysis was performed on clinical data of 37 adult acute lymphoblastic leukemia received Allogeneic hematopoietic stem cell transplantation.Of which 17 cases therapied through UCBT with a median age of 25（14~37）years、the median weight of 55（31~84） kg、82% for male,15 cases in UCBT group（88%）were refractory or high-risk patients.HLA mismatched transplants accounted for 94%;20 cases of sPB/BMT with a median age of 23.5（14~48）years,median weight of 61（44~83） kg,males accounted for 55%,12 refractory or high-risk patients（60%） in sPB/BMT group,HLA mismatched transplants accounted for 10%.Results UCBT group with the median follow up period of 9（1.3~58） months,88% of which use radiotherapy-based myeloablative conditioning regimen.Infused nucleated cell dose3.55（1.85～6.7）×107/ kg and CD34＋ cell dose 2.77（0.935～5.24）×105/ kg.sPB/BMT group with the median follow up period of 10.75（2~60）months,86% of which use chemotherapy-based myeloablative conditioning regimen,Infused nucleated cell dose 5.17（3.37～8.23）×108/ kg and CD34＋ cell dose 3.66（2.12～7.04）×106/ kg.16 patients（94%）of UCBT group achieved stable engr anment,1 cases relapsed in central nervous system,1 case relapsed in bone marrow.The incidence of acute GVHD（aGVHD,by day ＋100） was 0.5 and 0.125 for grade II-IV,The estimated 2 years overall survival（OS） was（68±12.2）%.All patients achieved stable engranment in sPB/BMT group,2 cases relapsed in central nervous system,3 cases relapsed in bone marrow,the incidence of aGVHD was 0.40 and 0.25 for grade II-IV,The estimated 2 years overall survival（OS） was（46.9±12.7）%.Conclusion Allogeneic hematopoietic stem cell transplantation is an effective way to treat acute lymphoblastic leukemia of adult,UCBT group have the slight