纯化的自体外周血造血干细胞移植治疗难治性幼年型类风湿性关节炎的初步研究

目的探索采用纯化的自体外周血造血干细胞移植治疗难治性幼年型类风湿性关节炎的临床效果。方法对3例难治性幼年型类风湿性关节炎患者进行纯化的CD34+细胞移植,动员得到外周血单个核细胞分别为8.23×108/kg、11.94×108/kg和9.32×108/kg;经CliniMACS CD34+细胞分选仪分选后得到CD34+细胞数分别为7.32×106/kg、8.75×106/kg和5.37×106/kg。采用BEAM+ATG预处理方案。结果发热的2例患者体温均降至正常,大关节肿痛均完全消失,四肢活动自如,血沉、C反应蛋白、类风湿因子各项指标正常,随访中疾病仍呈稳定状态。结论采用纯化的自体外周血造血干细胞移植可使患者造血功能得到较快重建,近期临床症状改善,是有效和安全的。

Study of purified autologous peripheral blood stem cell transplantation in treatment of patients with refractory juvenile rheumatoid arthritis

Objective To explore the clinical effect of purified autologous peripheral blood stem cell transplantation in treatment of patients with refractory juvenile rheumatoid arthritis（JRA）.Methods Three cases of refractory juvenile rheumatoid arthritis in patients with purified CD34＋cell transplantation,mobilized peripheral blood mononuclear cells obtained were 8.23×108/kg,11.94×108/kg and 9.32×108/kg.The CliniMACS CD34＋cell sorter sorting CD34＋cells obtained was 7.32×106/kg,8.75 ×106/kg and 5.37×106/kg.BEAM＋ATG conditioning regimen used.Results The 2 patients with fever were reduced to normal temperature,large joint swelling and pain are completely gone,limbs move freely,erythrocyte sedimentation rate（ESR）,C reactive protein（CRP）,rheumatoid factor（RF）indicators normal,During follow-up,the disease continued to show a steady state.Conclusion The purified autologous peripheral blood stem cell transplantation in patients with hematopoietic function can be rapidly rebuilt,and improvement of clinical symptoms,is effective and safe.