氨磷汀联合红系生成素治疗高龄单纯红系再生障碍性贫血近期疗效观察

Short-term Curative Effect of Amifostine Combined with rhβ-EPO on Patients with Pure Erythroid Aplasia

本研究旨在观察氨磷汀(AMF)联合重组人β红系生成素(rhβ-EPO)对单纯红系再生障碍性贫血(PEA)患者的近期疗效及副作用。采用AMF联合rhβ-EPO治疗2例高龄PEA患者。治疗方案为AMF0.4g静脉滴注,5天为1疗程,休息2天,连续3疗程为1个治疗周期;rhβ-EPO 6000U,皮下注射,1周3次。结果显示:2例PEA患者外周血的红细胞数、血红蛋白、网织红细胞在治疗后明显上升,骨髓中红系比例增高,治疗后输血间隔逐渐延长,输血量较治疗前明显下降,改善了患者的生活质量。而AMF副作用主要表现为胃肠道反应,患者均可耐受。结论:氨磷汀联合rhβ-EPO可能是高龄单纯红系再生障碍性贫血患者一种新型、安全、有效的方法,其远期疗效及作用机制尚需进一步探讨。

The aim of this study was to investigate the curative effects of amifostine （AMF） combined with recombinant human β- erythropoietin （rhβ-EPO） on patients with pure erythroid aplasia （PEA）. Two patients with PEA were treated with amifostine and rhβ-EPO. The therapeutic regimen was adopted with AMF 0. 4 g/day given by intravenons injection for 5 days first, then after a break of 2 days it went on for 3 weeks consecutively, that was considered as one treatment cycle. The rhβ-EPO 6 000 U was used by subcutaneous injection for 3 times per week. The results showed that the red cell count , hemoglobin and reticulocyte count of two patients obviously increased after treatment. The erythroid ratio in bone marrow increased. Bone mairow biopsy showed that the erythroid proliferation improved. Intervals of red cell transfusions （RCT） in the two patients who live by red cell transfusion were prolonged after AMF treatments, and the amounts of each RCT was decreased obviously. The main side effect of amifostine was discomfort of digestive system, but was tolerated by all patients. In conclusion, amifostine plus rhβ-EPO may be a new, effective and safety method especially for the elder PEA patients. The long-term curative effects and mechanism of amifostine still need further evaluation.