HLA半相合骨髓移植治疗极重度骨髓型急性放射病（附两例报告）

HLA-HAPLOTYPE IDENTICAL BONE MARROWTRANSPLANTATION FOR THE EXTREMELY SEVEREBONE MARROW FORM OF ACUTE RADIATIONSICKNESS(WITH TWO CASE REPORT)

１９９０年６月２５日，上海发生一起钴辐射事故，７人在短时间内受到大剂量、高剂量率、相对均匀的γ线照射。其中两例受照剂量达１１Ｇｙ和１２Ｇｙ，诊断为极重度骨髓型急性放射病。两例在紧急情况下分别于受照后第７天和第１１天进行了ＨＬＡ半相合的骨髓移植（ＢＭＴ）。其中一例５３岁，骨髓完全植活，造血重建，并成功防治了急性移植物抗宿主病，但于照后第９０天死于间质性肺炎。另一例５６岁，于受照后第２５天死于肺部出血和深部真菌感染。作者对事故性放射病骨髓移植的适应证、追加预处理等问题进行了讨论。

n the ￣(60)Co radiation accident happened in Shanghaion June 25,1990,seven people were accidentally ex-posed to high doses of relatively homogeneous totalbody radiation in a very short time.Two victims,whoreceived estimated doses of 11 and 12Gy,respectively,were diagnosed as extremely severe bone marrow formof acute radiation sickness, In the critical condition,they received HLA-haplotype identical bone marrowtransplantation at day 7 and day 11 after radiation,re-spectively. One patient,53 years old,had completeengraftment and hematopoietic recovery after trans-plantation,which was demonstrated by bone marrowhistology, HLA typing,cytogenetics and moleculartechniques,Acute graft-versus host disease(GVHD)was successfully controlled.Unfortunately,he died ofinterstitial pneumonitis at day 90 after the accident.Another,56 vears old,survived for 25 days after radi-ation and died of pulmonary hemorrhage and systemicfungal infection.