自体骨髓干细胞移植治疗系统性红斑狼疮的临床研究

Autologous bone marrow stem cell transplantation for systemic lupus erythematosus

目的 :探讨自体骨髓干细胞移植 (ABMSCT)对系统性红斑狼疮 (SLE)的临床疗效。方法 :3例患者采集自体骨髓移植CD34+ 造血干细胞 ,预处理用环磷酰胺 (CTX) 6 0mg/kg连续 2d静脉滴注 ,马法兰 14 0mg/m2 分次口服 ,抗CD3、CD8单抗各 5mg/d连续 5d静脉滴注 ,用粒细胞集落刺激因子 (G CSF)协助造血及免疫重建 ,用间接免疫荧光法检测抗核抗体、放免法测抗DNA抗体、流式细胞仪测淋巴细胞亚群 ,观察ABMSCT前后临床表现和免疫学指标的变化。结果 :ABMSCT后患者的临床症状明显缓解 ,异常免疫学指标恢复正常 ,抗体全部转阴。结论 :ABMSCT对SLE有较好的近期疗效 ,远期疗效还需长期随访。

Objective:To investigate therapeutic effect of autologous bone marrow stem cell transplantation (ABMSCT) for systemic lupus erythematosus (SLE).Method:Autologus bone marrow stem cell transpluntation was adopted in 3 patients. The conditioning before transplantation consisted of 60 mg/kg intravenous cyclophosphamide(CTX) for two days, 140 mg/m 2 oral malphalan and five days injection of anti-CD3 and anti-CD8(5 mg/d, respectively). The recovery of hematopoiesis and immune function were stimulated by G-CSF. Indirect immunofluorescent and radioimmunologic tests were used to examine ANA and anti-DNA. Lymphocyte subsets were analyzed by flow cytometry.Result:Both clinical manifestations and immunologic abnormality returned to normal. All antibodies were negative.Conclusion:ABMSCT for SLE has been remarkably effective within 3 months. It is required to follow-up for evaluating long term effect.