非亲缘HLA相合骨髓移植治疗一例骨髓增生异常综合征

为了探讨非亲缘HLA相合供者骨髓移植 (UD BMT)治疗骨髓增生异常综合征 (MDS)的可行治疗方案和疗效 ,采用HLA配型相合的非亲缘骨髓移植治疗 1例骨髓增生异常综合征 难治性血细胞减少伴多系病态造血(MDS RCMD)男性患者 ,31岁。预处理方案为马利兰、环磷酰胺、阿糖胞苷、甲基环己亚硝脲和抗胸腺细胞球蛋白。以霉酚酸酯、环孢菌素A加短疗程的甲氨喋呤预防移植物抗宿主病 (GVHD)。结果显示 ,移植后 10天中性粒细胞 (0 .5× 10 9 L ,2 0天血小板升至 5 8× 10 9 L ,3个月血红蛋白升至 114g L ,无GVHD发生 ;移植后无病存活时间已达 9个月。结论 :非血缘HLA相合骨髓移植治疗骨髓增生异常综合征是可行而且有效的。

Unrelated HLA-Matched Donor Marrow Transplantation for One Case of Myelodysplastic Syndrome

To explore feasibility and efficacy of unrelated HLA matched donor marrow transplantation in treatment of myelodysplastic syndrome, one case (male, 31 years old) of myelodysplastic syndrome-refractory cytopenia with multilineage dysplasia (MDS-RCMD) has been received unrelated HLA-matched donor transplantation. Busulfan, cyclophosphamide, Ara-C, MeCCNU and antithymocyte globulin (ATG) were used for preparative regimen. Mycophenolate mofetile, cyclosporin A and short-term methotrexate were used for graft-versus-host disease prophylaxis. The results showed that neutrophil of > 0.5 x 10(9)/L, platelet of 58 x 10(9)/L and hemoglobin of 114 g/L were observed at 10, 20 days and 3 months respectively post transplantation. Disease-free survival without GVHD was 9 months. In conclusion, unrelated HLA matched donor marrow transplantation is an effective approach for treatment of patients with MDS.