异基因骨髓移植治疗重型再生障碍性贫血

ENGLISH ABSTRACTS OF ORIGINAL ARTICLESCLINICAL OBSERVATIONS ON ALLOGENEIC BONEMARROW TRANSPLANTATION FOR SEVEREAPLASTIC ANEMIA

采用大剂量抗淋巴细胞球蛋白、环磷酰胺的非照射预处理方案对３例重型再生障碍性贫血患者进行了异基因骨髓移植（ａｌｌｏ－ＢＭＴ）治疗。３例患者均为男性，年龄分别为２８岁，２１岁，２０岁，病程分别为２周，３周，８周。诊断到骨髓移植平均为２４日。移植后均给予ＧＣＳＦ３００μｇ·ｍ￣（－２）·ｄ￣（－１）和的Ｍ－ＣＳＦ８００ＩＵ／ｄ。两例患者已分别正常生存３４￣＋月和３２￣＋月，其染色体及红细胞酶检查，均为供者型（４６ＸＸ）。另一例输血后移植的病例发生免疫排斥反应而死亡。２例移植成功的患者骨髓恢复造血的时间提前，中性粒细胞达＞０．５×１０￣９／Ｌ分别是１３日和１５日，免疫功能恢复时间也提前，Ｔ细胞亚群在术后３个月内恢复正常。作者阐述了预处理方案的机制，并指出联合应用细胞因子有协同造血和促进免疫恢复的功能，认为ａｌｌｏ－ＢＭＴ后６个月内不直接种疫苗。

llogeneic bone marrow transplantations(allo-BMT)were performed for three severe aplastic anemiapatients with a conditioning regimen consisted of anti-lymphocytic globulin and high dose cyclophosphalnide-After allo-BMT,these three patients were given G-CSF 300μg·m￣(-2)·d￣(-1) and M-CSF 800IU/d. Two ofthem have been alive in normal status for 3 4￣+ and 32￣+months,respectively,Chromosome and RBC enzymeanalyses both showed the corresponding phenotypes ofthe female donors'in the two male recipients. Thethird patient who received blood transfusions beforethe operation , died of rejection, Hematopoietic recov-ery time in the two patients was shorter than usual,and the absolute neutrophil count reached 0.5 × 10￣9/Lat dav 12 and day 15 post-transplant,respectively.