造血干细胞移植后的移植物抗宿主病

Graft-Versus-host Disease After Hematopoietic Stem Cell Transplantation

本院14例异基因骨髓移植中发生急性移植物抗宿主病7例(50％),其中Ⅳ级2例(14.3％)。Ⅰ～Ⅱ级5例;慢性移植物抗宿主病2例(14.3％)。9例胎肝移植中1例发生移植物抗宿主病Ⅰ级。1例自体骨髓移植后因输未经照射的异体血引起急性移植物抗宿主病。收集1988年至1991年12月国内文献报告异基因骨髓移植57例,发生急性移植物抗宿主病44例(77.19％),Ⅲ级以上12例(20.05％),慢性移植物抗宿主病14例(24.56％)。初步分析我国移植物抗宿主病的发病率与欧美早期报告近似。本文结合国内外文献报告介绍了移植物抗宿主病的防治措施。

Graft-versus-host disease (GVHD) is one of the major complications in allo-BMT and is also reported in other types of hematopoietic stem cell transplantation. In 14 patients treated with allo-BMT, 7 patients (50％) were complicated by acute GVHD (grade Ⅳ: 2 cases, grade Ⅰ-Ⅱ: 5 cases) and 2 patients were complicated by chronic GVHD. One patient with grade Ⅰ GVHD in 9 cases treated with fetal liver transplantation was observed. One patient developed acute GVHD following infusion of non-irradiated allo-blood after ABMT. From Jan. 1988 to DEC. 1991, 57 patients treated with alIo-BMT had been reported in our country. The incidence of acute GVHD was 77.19% (grade Ⅲ-Ⅳ: 12 cases in 44 cases, 24.56%) and that of chronic GVHD was 24.56%. The result showed that the incidence of GVHD in our country was similar to that reported early in Europe. Otherwise, prevention and treatment of GVHD were also discussed in this paper.