目的：探讨急性髓性白血病（acute myelogenous leukemia，AML）患者采用自体外周血干细胞混合HLA半相合异体骨髓移植（autologous peripheral blood stem cell mixed with HLA haploidentical allogeneic bone marrow transplantation, Mixed-HSCT）联合供体淋巴细胞输注+白介素2（donor lymphocyte infusion combined interleukin-2，DLI-IL-2）治疗的疗效。方法：采用联合治疗方案的试验组23例AML患者中男性15例、女性8例，中位年龄22（17~41)岁；采用单纯移植治疗的对照组14例AML患者中男性10例、女性4例，中位年龄21(19~40)岁。两组患者在完全缓解期采用TBI+VEMAC方案预处理，对照组患者接受单纯Mixed-HSCT移植，试验组患者接受Mixed-HSCT且造血重建后继续DLI-IL-2治疗1～8次；各组在治疗前后进行染色体核型分析及骨髓检查。随访时间>3年。结果：两组患者均获得造血重建，无移植物抗宿主病（graft-versus-host disease, GVHD）发生。试验组有6例形成混合嵌合体（46XX/46XY），随访显示存活15例，长期无病存活率（disease-free survival, DFS）为652%；对照组有3例形成混合嵌合体（46XX/46XY），随访显示存活7例，DFS为50.0%。两组患者治疗后的不良反应（口腔溃疡、出血性膀胱炎、发热等）相似。结论：Mixed-HSCT联合DLI-IL-2治疗对AML患者长期无病生存有积极意义，无严重不良反应。

Objective:To study the efficacy of mixed-HSCT (autologous peripheral blood stem cell mixed with HLA haploidentical allogeneic bone marrow transplantation) combined with donor lymphocyte infusion plus interleukin-2 (DLI+IL-2) in treatment of acute myelogenous leukemia (AML) patients. Methods: Twenty-three AML patients (15 males and 8 females, median age 22 years) were enrolled in this study as mixed-HSCT combined DLI+IL-2 group, and 14 AML patients (10 males and 4 females, median age 21 years) were enrolled as control group. All patients in the two groups received TBI+VEMAC therapy after complete remission, patients in the control group were treated with mixed-HSCT alone, and those in the experimental group were treated with Mixed-HSCT and further treatment with DLI+IL-2 for 1-8 times after hematopoietic reconstruction. All the patients were followed up for at least 3 years. Results: All patients in the two groups achieved hematopoietic reconstruction and had no graft-versus-host disease (GVHD). During 3 years, 6 cases in the experimental group formed mixed chimerism (46XX/46XY) and 15 survived, with the disease-free survival rate (DFS) being 65.2%. Three cases in the control group formed mixed chimerism (46XX/46XY) and 7 cases survived, with the DFS being 50.0%. All patients in the two groups had similar adverse reactions (oral cavity ulcer, hemorrhagic cystitis, fever, etc.) after therapy. Conclusion: Mixed-HSCT combined with DLI+IL-2 has a positive effect on DFS of AML patients, with no noticeable adverse reactions.

全军“十一五”杰出人才基金资助项目（No.06J005），兰州军区医药科研基金项目（No. LXH-2007006）