改良非清髓造血干细胞移植治疗重型再生障碍性贫血

Improved nonmyeloablative allogeneic peripheral blood stem cell transplantation for severe aplastic anemia

目的总结非清髓性造血干细胞移植（NSCT）治疗两种类型重型再生障碍性贫血（SAA）的临床经验。方法对17例SAA患者进行NSCT，预处理主要采用小剂量环磷酰胺、抗淋巴细胞球蛋白或抗胸腺细胞球蛋白；移植后采用环孢素、吗替麦考酚酯（商品名：骁悉）预防移植物抗宿主病。结果9例（75％）SAAI型患者及3例（60％）SAAⅡ型患者获得迅速造血重建、植入率高、并发症少且轻，预后佳。结论NSCT是治疗SAA的有效措施。

Objective To summarize the experience of improved nonmyeloablative hematopoietic stem cell transplantation（NSCT） in the treatment of severe aplastic anemia. Methods Seventeen patients with Severe Aplastie Anemia received NSCT after a nonmyeloablative conditioning.The patients were conditioned with decreased dosage of immunosuppressive agents of CTX and anti-lymphoid cell globulin or anti-thymus gland cell globulins; CsA and MMF were used to prevent the graft-versus-host disease （GVHD） after transplantation. Results 75 % of severe aplastic anemia in patients with type I and 60 % of severe aplastic anemia in patients with type Ⅱ achieved rapid hematopoietic reconstitution, with good prognosis and implantation rate with fewer complications and light symptoms were observed. Conclusion NSCT is an effective treatment of severe aplastic anemia.