同基因外周血造血干细胞移植治疗再生障碍性贫血

SYNGENEIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION FOR APLASTIC ANEMIA

目的研究同基因外周血造血干细胞移植治疗急性和慢性再生障碍性贫血的疗效及移植后造血功能恢复的情况。方法采集单卵双生兄妹供者外周血造血干细胞,对病人经180 mg/kg环磷酰胺预处理后,回输造血干细胞,观察造血功能恢复情况。结果2例病人造血功能均获得重建。粒细胞>0.5×109/L的时间分别为11和12 d。血小板>20×109/L的时间分别为10和11 d。移植14 d后2例病人的中性粒细胞、血小板计数和血红蛋白分别为1.0×109/L、1.2×109/L、67 g/L和52×109/L、59×109/L、76 g/L。移植后第28天病人的中性粒细胞、血小板计数和血红蛋白分别为2.3×109/L、2.5×109/L1、06 g/L和152×109/L、259×109/L、115 g/L,骨髓增生活跃。例1移植后4个月发生迟发性移植物排斥反应,例2观察16个月,血常规及骨髓检查正常。结论同基因外周血造血干细胞移植是治疗急性和慢性再生障碍性贫血的有效方法,有造血功能恢复快之优点。

Objective To study the effectiveness of syngeneic peripheral blood stem cell transplantation in the treatment of aplastic anemia, Methods Syngeneic peripheral blood stem cells （PBSCs） were collected from homozygotic-twin brother or sister donators. Cyclophosphamide （180 mg/kg） was given to the patients before PBSCs were infused. Results The function of hematogenesis recovered in both patients. The neutrocytes were more than 0.5×10^9/L on 10 d and 11 d. The platelets, more than 20×10^9/L on 11 d and 12 d. Neutrocyte, hemoglobin and platelet were 1.0×10^9/L, 67 g/L, 52×10^9/L and 1.2×10^9/L, 765 g/ L, 59×10^9/L on the 14th day, 2.3×10^9/L, 106 g/L, 152×10^9/L and 2.5×10^9/L, 115 g/L, 259×10^9/L on the 28th day, respectively. Late-graft rejection occurred in case one four months after transplantation; and ease two, the blood and bone marrow maintained stable during 16-month observation. Conclusion Syngeneic HSCT is an effective method for acute and chronic aplastic anemia with the merit of rapid recovery of hematogeneais.