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含与不含抗胸腺细胞球蛋白的两种预处理方案早期毒性的比较 被引量:4

A comparative study on early toxicity of conditioning regimen with or without antithymocyte globulin
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摘要 目的比较采用改良白消安/环磷酰胺(Bu/Cy)方案及改良Bu/Cy+抗胸腺细胞球蛋白(ATG)方案进行预处理的异基因造血干细胞移植(HSCT)患者在预处理期间及移植后早期发生的相关毒性。方法100例血液系统恶性肿瘤患者中,应用改良Bu/Cy方案者(A组)42例,应用改良Bu/Cy+ATG方案者(B组)58例,主要观察预处理期间及移植后早期出现的非感染性发热、腹泻、肝毒性、黏膜炎及血液系统毒性。结果A、B两组发热发生率分别为4.8%和81.0%,转氨酶升高发生率分别为59.5%和65.5%,胆红素升高发生率分别为16.7%和48.3%,腹泻发生率分别为59.5%和79.3%,黏膜炎发生率分别为45.2%和37.9%。白细胞进入零期的中位时间分别为+3d和-3d;-10d内需输注红细胞及血小板的比例分别为11.9%和32.8%,16.7%和82.8%。结论含ATG的预处理方案组发热,腹泻,肝损害,白细胞、红细胞和血小板降低的发生率明显高于不含ATG的预处理方案组,这种改变很可能与ATG相关。 Objective To evaluate the toxicity of conditioning regimens of modified Bu/Cy +/- antithymocyte(ATG) in early stage after allogeneic hematopoietic stem eel1 transplantation (allo-HSCT). Methods A hundred patients with hematological malignancies undergoing allo-HSCT were assessed. Fortytwo patients (group A) were conditioned with modified Bu/Cy regimen, 58 (group B) with modified Bu/Cy + ATG regimen. The occurrence of toxicity during the early stage after transplantation was evaluated and compared, including non-infectious fever, diarrhea, hepatotoxieity, mucositis and hematological toxicity. Results In group A and B, the incidence of non-infectious fever was 4.8% vs 81.0% , transaminase elevation 59.5% vs 65.5% , bilirubin elevation 16.7% vs 48.3% , diarrhea 59.5% vs 79.3% and mncositis 45.2% vs 37.9% , respectively, white blood cells reached zero occurred at a median of +3 d and -3 d, the rate of red cell and platclet transfusion-dependence ,within l0 days before transplantation was 11.9% vs 32.8 and 16.7% vs 82.8% , respectively. Conclusions Significant higher incidence of non-infectious fever, diarrhea, hepatotoxicity, leucocytopenia,and transfusion dependence is found and considered to be related to the administration of ATG in the conditioning regimen.
出处 《中华血液学杂志》 CAS CSCD 北大核心 2009年第8期519-523,共5页 Chinese Journal of Hematology
关键词 抗胸腺细胞球蛋白 毒性 预处理 造血干细胞移植 Antithymoeyte globulin Toxicity Conditioning Hematopoietie stem cell transplantation
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参考文献13

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二级参考文献15

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