造血干细胞移植治疗重症再生障碍性贫血

分别采用同基因ＢＭＴ及异基因ＢＭＴ治愈重症再生障碍性贫血（ＳＡＡ）各１例。例１经各种基因标志分析识别其与孪生兄弟为同卵双生，故采用单纯输注骨髓辅以ＧＭ ＣＳＦ，使其治愈，已逾４年。例２经ＨＬＡ血清学、细胞学和ＤＲＢＰＣＲ／ｐｒｉｎｔｉｎｇ配型证实与其弟ＨＬＡ基因型相合，以Ｃｙ＋ＡＴＧ为预处理方案，移植骨髓细胞及外周血干细胞，用ＣＳＰ＋ＭＴＸ预防ＧｖＨＤ，移植物于＋１４ｄ植活，＋６１ｄ其ＲＢＣ抗原由ＭＮ转为ＮＮ供者型，现正在康复之中。

Haemopoietic Stem Cell Transplantation for Treatment of Severe Aplastic Anemia

Two patients with severe aplastic anemia(SAA)treated by syngeneic BMTand allogeneic BMTplus peripheral blood stem cell transplantation(PBSCT)respectively were reported. The patient suffering from SAA Ⅱ had an identical twin brother. He received brother's marrow transfusion(1.5×10⁸/kg)alone and had sustained recovery of PBcounts and marrow haemopoiesis.He is alive and works normally more than 4 years. Another patient with very SAA(vSAA)and had an HLAfull matched(HLAtyping, cross matched MLCand DRB PCR/printing)brother as donor. He had received previous transfusion 12 times. He was administered four daily doses of Cy(50 mg/kg×4, total 200 mg/kg)alternating with three doses of ATG(25 mg/kg×3, total 75 mg/kg)followed by a HLAidentical marrow graft(2.7×10⁸ /kg,0 d)and peripheral blood stem cell(PBSC)transfusion(CD34⁺cells 3.85×10⁵/kg,+1 d). Methotrexate(MTX)and cyclosporine A(CSP)were administered to prevent GvGH. His PMNs increased more than 0.2×10⁹/Lsince +14 days and RBCantigen from MNbecame NN(donor′s source)at +61 d. However,he was complicated with systemic MRSAinfection since +12 d and followed by abscess of thoracic vertebra.The managements for abcess were effective and the patient is recovering. The article also discussed some problems with treatment of SAA.