自体外周血造血干细胞移植患儿的远期随访

A long term follow up study on survivors after autologous peripheral blood stem cell transplantation

为探讨自体外周血造血干细胞移植（Ａｕｔｏ－ＰＢＳＣＴ）预处理的远期毒副作用，对８例Ａｕｔｏ－ＰＢＳＣＴ术后生存４～８年的恶性肿瘤患儿进行了随访。结果，８例患儿生长发育、神经精神发育、肾上腺皮质功能及免疫功能均正常。７例患儿甲状腺功能正常，１例发生代偿性甲状腺功能低下。５例进入青春期的患儿中４例性腺功能基本正常，１例男性性腺发育迟缓（伴有继发性血色病）。发现轻度白内障５例。５例丙型肝炎抗体阳性，其中４例肝功能异常，１例患乙型肝炎。提示，恰当的预处理方案对患儿远期生长发育、神经精神系统、内分泌、免疫系统无影响或影响较小，但轻度白内障发生率高，乙型肝炎、丙型肝炎在其治疗过程中的预防应引起重视。

To investigate the late side effects of autologous peripheral blood stem cell transplantation (Auto PBSCT) in children, 8 survivors of 4～8 years after Auto PBSCT were followed up. Growth, neuropsychological development and immune function were normal. Thyroid function was normal in 8 patients except one who developed slight compensated hypothyroidism. Five children were puberty evaluable. The puberty development was normal in four and delayed in a male patient. Slight cataract was noticed in five patients. Serum hepatitis C antibody was positive in 5 cases, of whom 4 had abnormal liver function. One patient suffered from hepatitis B. These data suggest that the conditioning regimen used is associated with little side effects on growth, neuropsychological development and endocrine system as well as immune function, but with high incidence of cataract. Also, great attention should be paid to the prevention and treatment of hepatitis B and C.