HLA全相合异基因造血干细胞移植与免疫抑制剂治疗重型再生障碍性贫血的比较

背景：国外有报道显示异基因造血干细胞移植和免疫抑制疗法治疗急性重型再生障碍性贫血的有效率及总生存期相当,但两种疗法治疗后的生活质量及治疗费用方面的差异报道较少。目的：回顾性分析同胞HLA全相合异基因造血干细胞移植与免疫抑制疗法治疗急性重型再生障碍性贫血的疗效。方法：入选2004-07/2010-10在南京鼓楼医院血液科行同胞HLA全相合异基因造血干细胞移植的7例及行免疫抑制疗法的16例急性重型再生障碍性贫血患者,每3个月定期进行随访。结果与结论：异基因造血干细胞移植组在粒细胞和血小板恢复时间,脱离输血时间,治疗后3个月总有效率及治疗后12个月完全缓解率均优于免疫抑制疗法组,但治疗后12个月总有效率差异无显著性意义。异基因造血干细胞移植组与免疫抑制疗法组的总生存率分别为86%与81.3%,两组比较差异无显著性意义。治疗1年后两组患者总体健康状况及功能健康状况均提示良好,两组住院费用差异无显著性意义。

Allogeneic hematopoietic stem cell transplantation versus immunosuppressive therapy as frontline treatment for severe aplastic anaemia

BACKGROUND：Foreign reports have suggested that allogeneic hematopoietic stem cell transplantation（HSCT） and immunosuppressive therapy（IST） for acute severe aplastic anemia（SAA） have similar clinical effectiveness and overall survival period,but there are few reports about post-treatment quality of life and treatment costs of two different therapies.OBJECTIVE：To summarize the outcome and survival of both HLA matched sibling donor HSCT（allo-HSCT） and IST in 23 SAA patients.METHODS：Totally 7 patients with SAA who received allo-HSCT and 16 patients with SAA who received IST were selected from Department of Hematology,Nanjing Drum Tower Hospital from July 2004 to October 2010.Follow-up was performed every 3 months after treatment to observe the patients＇ survival,quality of life,cost of hospitalization and analyze the effects.RESULTS AND CONCLUSION：The allo-HSCT therapy was better than the IST therapy in the neutrophil and platelets recovery speed,the time of transfusion,the overall response rate after 3 months and the complete response rate after 1 year（P 0.05）.The overall survival rates of the two therapies were 86% and 81.3% respectively,which had no significant difference（P 0.05）.The quality of life was good at 1 year after treatment.There was no statistically significant difference between the two therapies in total efficacy rates,physiological state,psychological state,social relationships,and environmental condictions one year later.The costs of hospitalization between the two groups were similar.