异基因造血干细胞移植对重型再生障碍性贫血的疗效 |
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引用本文: | 韩波,孟繁军,乌庆超.异基因造血干细胞移植对重型再生障碍性贫血的疗效[J].康复与疗养杂志,2011(4):341-343. |
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作者姓名: | 韩波 孟繁军 乌庆超 |
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作者单位: | [1]青岛大学医学院附属青岛市海慈医疗集团血液科,山东青岛266033 [2]青岛大学医学院附属医院血液科,山东青岛266033 |
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摘 要: | 目的探讨异基因造血干细胞移植(Allo-HSCT)治疗重型再生障碍性贫血(SAA)临床效果。方法 6例接受Allo-HSCT的SAA病人均为血缘供者,其中SAA-Ⅰ型4例,SAA-Ⅱ型2例。预处理方案为氟达拉滨+环磷酰胺+兔抗人胸腺细胞球蛋白。移植物抗宿主病(GVHD)预防采用环孢菌素A+短程甲氨蝶呤+骁悉方案。结果 6例病人移植后均获造血重建,其中性粒细胞〉0.5×109/L和血小板〉20×109/L的中位时间分别为移植后13.51、7.5 d。经微卫星技术检测造血干细胞植入率为100%。移植后1例出现Ⅱ度肠道急性GVHD,1例出现Ⅰ度皮肤急性GVHD,1例出现皮肤广泛型慢性GVHD。随访4~82个月(中位时间30个月),5例SAA病人存活,1例皮肤慢性广泛型GVHD并发肺部混合感染死亡。结论 Allo-HSCT是治疗SAA的可靠有效方法。
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关 键 词: | 造血干细胞移植 贫血 再生障碍性 治疗结果 |
THERAPEUTIC EFFICACY OF ALLOGENEIC HEMOTOPOIETIC STEM CELL TRANSPLATION FOR PATIENTS WITH SEVERE APLASTIC ANEMIA |
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Authors: | HAN BO MENG FAN-JUN WU QING-CHAO |
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Institution: | (Department of Hematology,The Affiliated Haici Hospital of Qingdao University Medical College,Qingdao 266033,China) |
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Abstract: | Objective To evaluate the effect of allogeneic hemotopoietic stem cell transplantation(Allo-HSCT) in the treatment of patients with severe aplastic anemia(SAA). Methods Six SAA patients received Allo-HSCT from consanguineous donors,of whom,four were type SAA-Ⅰ,and two were SAA-Ⅱ.Preparative regime was a combination of fludarabine(Flu),cyclophosphamide(CTX) and rabbit anti-human thymocyte globulin(ATG).A combination of cyclosporine A(CSA) with short-range methotrexate(MTX) and mycophenolate mofetil(MMF) was adopted for prophylaxis of graft-versus-host-disease(GVHD).Results All of the six patients showed reconstruction of hematogenesis after Allo-HSCT.The median time of neutrophils reached 0.5×109/L was 13.5 days,and that of platelets reached 20×109/L was 17.5 days.Implantation rate of hematopoietic stem cells was 100% in all patients detected by microsatellite technology(STR-PCR).After transplantation,one patients appeared acute grade Ⅱintestinal GVHD,one acute gradeⅠskin GVHD,and one with chronic extensive skin GVHD.Five patients survived during a follow-up of 4-82 months,median being 30 months,one with chronic extensive skin GVHD died of pulmonary mixed infection. Conclusion Allogeneic hematopoietic stem cell transplantation is a reliable and effective therapy for severe aplastic anemia. |
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Keywords: | hemotopoietic stem cell transplantation anemia aplastic treatment outcome |
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