???????(SCT)????????,??: (1)?????????(ASCT) (2)????????????(Allo-SCT) (3)?????????(SCT)?

1
???????
2
???????(SCT)????????,??(1)?????????(ASCT)(2)???
?????????(Allo-SCT)(3)?????????(SCT)?
3
??????????????(1)????(BMT)(2)??????????(PBSCT)
(3)?????????(NCSCT)(4)?????????(NLSCT)
4
? ? ? ?
5
????(??BMT)??????????????,??????????????,?????
?????????????,??????????,????????????????
6
???????? ?????????,??????????????(ABMT)????
?????(Allo-BMT)?????????(SBMT)??????
7
(?)??????(ABMT) ????????????
???????,????????/???,????????????????,?????????,??
??????? ??????????????????(GVHD)??????,???????
?,??????
8
ABMT?????????????????????,????????????????????
????????????????????????????,??????????????????
???????????????
9
??????????? ???????????????????????????,??????
???????????72??? ?????????????????,?????????
?-196??????
10
???????(??????????????????)??BMT,?????????????,???
??????,??????????????????GVHD,??????????,???????
11
(?)?????????(SBMT) ??????????????,????????????
????????,????????,????????GVHD,?????????
?????????????????????????,???????Allo-BMT??,??????
?????????????
12
(?)?????????(Allo-BMT) ??????????????????(??MH
C)?????????????? ?????????????????????????,???
??????,?????????(??HLA)?????????????,?????????
???GVHD,???????????ABMT?SBMT??
13
???????(?)??(??)?????(1)????250???(2)???????
??,??????????CR1?,???????CR2?????????????????(??
????),????????????????
14
(3)?????????(4)???????gt5.0??????(forced vital
capatity)60?????????(DLCO)50?(5)???lt110µmol/L
(2mg/dl)?????lt18µmol/L(lt2mg/dl)?
15
(?)???? ??HLA??????????????,??????????????ABO
????????? ???????????????????
16
??HLA???????????????,??HLA??????,???????
17
???????????(Allo-BMT)??????????(SBMT)(?)????1.?
??????????HLA??, ??PCR??HLA-A?B?C?DR????,?HLA??
????????????????????????
18
2.???? ???????????????,?????????????????????
?????????????-???????(GM-CFU)??????,??????????????
?????????????
19
?????????????????(????),?????????????????
??,???4????????????????600800???
20
3.???????????????????????????????????????????
???????????,??????,???????????,???????????????
????
21
?????????????????????????????????????,??????
?X??????????????????????
22
?????????,??????,????????????2030??,????????
?,?????????????? ?????????,?????,?????????????
??? ?????????????
23
4.???????? ??????????????,????????????????????
???????????
24
(1)???????????????????(CTX)????????????????(CT
XTBI)?(2)???????CTXTBI ????CTX????TBI
25
???? ????????????????????????,????????????,?
???????/????/?????,????????,??????????,???1015ml?
??,??1015ml/Kg(6001000ml)?
26
???????????????(?)????????????(1)SBMT?3.0-5.
0107/Kg(2)Allo-BMT?2.0-6.0108/Kg
????400ml?,???????????????,????,????????????
27
(2)?? ??17?18???????,?????(??0.2010.307mm)??
?????????????????????????1640???????,??????????15
20??,????????
28
(3)???????????????????????????????????????????,?
?????????,???????,??????????,????????????????????
??????????????(1mg??????100u??)?
29
(?)Allo-BMT??????(1)??????????????????????,????
??,?HLA(I?II??III?)??,?????????????,???????????,
???????????????????
30
(2)???????????????GVHD?(3)??????????2-4?,??????
??????????????????,????????????
31
????????(?)?????????? ????????????????????,?
???????????????????????????,?????????????
ABMT???????5.030.0109(0.55.0108/kg??),???????(
CFU-C)??1.04.0104/kg???
32
??????????????,?????(0.2010.307mm)??????,???
????????????????????????????15-20U,
4???3648??????????10?????????????,??????-196????
??
33
(?)???? ????????????????????????????????????
????????????????????????????????????????????????
?????????????????
34
(?)?????????? ABMT?????????????????,?????????
??????????????????? ?????CTX?????(TBI)???????
(FTBI)??????????????
35
(?)??????(?)?????????????(????)
ABMT????????????1.0109/L???16-21??????50109/L??
?14-21?,?????gt0.510 9/l,??21??
36
??????????
37
??????????? ?????????????(1)??????????(APBSCT
)(2)?????????????(Allo-PBSCT)?
?????????????????
38
??????????????(?)?? ????????,??????????,???????
????110,??,??????PBSCT????????????????1.?????
????
39
2.??????? (1)????????????????(2)?????????,?????
???????,???????????????????,????????????????????,?
?????????????25100?,????????????????????????????
???
40
??????????????????????????????
???????????????????????PBSCT?,????????????????????
???Allo-PBSCT?????GM-CSF?G-CSF?
41
(?)??1.??????(1)???????2-3?,??????????(1.0-2.0)
109/L??????G-CSF???????????(5.5-10.0)?,??????50
109/L(2)???CD34?????1(???0.2?0.1)?????????????
???????
42
2.?? ?????????Fenwall CS3000,??3-4??COBE
SPECTRA??1-2?,??????????????????
43
?????????? ???????????????????????????????
????PBSCT????????,CD34??????2.5106/kg???,?????CD
34?????????
44
??????????? ??????????????????????50ml,?????20
?????(DMSO)?RDMI1640???,?DMSO????????10?????????
???(??100ml)?
45
???????????1?/min????-45?,?????510?/min??-80?
-90?,?????,???????-196???????
46
??????,???????????????????4042????3min?????,
?????????DMSO???? ???RPMI1640?????,????400
600ml,?1?????????
47
??????????????? ?????????,????????????(PMN)??
???????? ???????PMN????
0.5109/L,????????11?,?????????,?????34?????????
?,??????????
48
???????PMN??????????????????????????????????
?????????????????????????? 50.0109/L?????13??
49
?????????
50
70????????????????????????????80?????????????
????????????????????????,?????????,???????????????
???????????
51
??????? ????????????,?????(1)???????(2)??
?????? ?????,?????ACD(????????????)?CPD(??????
??????)??????
52
?????????42-240(???103)ml,????????1.02.010
9/l,?????(MNC)1.0109,CD34??1.0107
??????????50????????????
53
????????? ??????????????????????????????????????
???????,???????????????????(1)????20DMSO(??????
?5,?????)(2)????????
54
????????????? ?????????????????,????????????????
??????????????????,??????????????????????????????
??T????????????,??GVHD?????
55
????????????????(1)?????????????(ANC)?5.0109/L??
?????????????22?,????????24??(2)??????5.0109/L
???????????????48?,????????54??
56
?????????
57
1958?Uphoff????????????????????????????????????
???????????36????????????????,???????????,???????
??????????????,??????????2,???????????T????.??,??
??GVHD????????????
58
?????????? ?????????????????????????????,????
??????????????????,??????????????????(??100-200?)?
???,?????20ml???,??10ml???????????????,???????,???
?4??????????????????
59
??????????????(?)?????????
??????????????1?T????,??,????????????????????????
????
60
?????15mm?10ml??????????????????,?????4??????
??????(1500?/min)20min?,???????????????,?????????,
????????????(CFU-GM)????7489?
61
(?)????????? ?????????????????????????11?????
,????????,???????????
62
??????? ???????
63
????????????????????????????,??????????????????
????(IPN)?All0-BMT????GVHD?????????,?????40?
64
???????? ?????????(HE)???????(????????)??????
???????????????????????????????????????????????
????????????????
65
??????? ????????
66
??????????(?)?????(?)????????(CGL)(?)?????(?)?
?????(?)?????????(?)?????(?)????
67
???????????(1)??????????????,???????????????,??
????,???????????????(2)?????????????T????,?????,H
LA??????,GVHD???????(BMT)????
68
(3)????????????????,???????,??????????????????(4)
???????????????,????????????(5)??????????????????
??