论文部分内容阅读
目的评价异基因外周血干细胞移植(Allo-PBSCT)治疗重型再生障碍性贫血(SAA)患者的安全性及疗效。方法回顾性分析接受Allo-PBSCT的SAA临床资料,其中接受同胞HLA相合供者移植8例,亲缘单倍体供者移植4例,非血缘移植4例;预处理方案为环磷酰胺+抗胸腺细胞球蛋白±氟达拉滨或环磷酰胺+白消安+抗胸腺细胞球蛋白;移植物抗宿主病(GVHD)预防方案联合应用环孢素+短程甲氨蝶呤±酶酚酸酯;输注单个核细胞(MNC)(5.3~69.5)×108·kg-1,中位数为7.5×108·kg-1,CD34+细胞(0.47~16.1)×106·kg-1,中位数为5.8×106·kg-1。结果 16例患者均获得造血重建,7例患者发生急性GVHD,2例患者发生慢性GVHD。无移植物排斥。移植后随访1~73个月,中位随访时间23个月,14例患者生存,移植相关死亡2例。预期5年总体生存率为(83±11)%。结论 Allo-PBSCT治疗SAA患者安全有效。
Objective To evaluate the safety and efficacy of allogeneic peripheral blood stem cell transplantation (Allo-PBSCT) in the treatment of patients with severe aplastic anemia (SAA). Methods The clinical data of SAA receiving Allo-PBSCT were retrospectively analyzed. Among them, 8 were HLA-matched donors, 4 were haploid donor and 4 were non-blood-transplanted. The pretreatment protocol was cyclophosphamide + Cycloglobin ± fludarabine or cyclophosphamide + busulfan + anti-thymocyte globulin; GVHD prophylaxis in combination with cyclosporin + short-course methotrexate ± enzyme phenolic ester; The median of mononuclear cells (MNC) (5.3 ~ 69.5) × 108 · kg-1 was 7.5 × 108 · kg-1 and CD34 + cells (0.47-16.1 × 106 · kg- 5.8 × 106 · kg-1. Results All 16 patients received hematopoietic reconstitution, 7 patients developed acute GVHD and 2 patients developed chronic GVHD. No graft rejection. The patients were followed up for 1 to 73 months after transplantation. The median follow-up time was 23 months. There were 14 patients who survived and 2 patients died of transplantation. The 5-year overall survival rate is expected to be (83 ± 11)%. Conclusion Allo-PBSCT is safe and effective in the treatment of SAA.