自体骨髓干细胞移植治疗系统性红斑狼疮的临床研究

Autologous marrow stem cell transplantation for systemic lupus erythematosus

目的 探讨自体骨髓干细胞移植（ Ａ Ｂ Ｍ Ｓ Ｃ Ｔ） 对系统性红斑狼疮（ Ｓ Ｌ Ｅ） 的疗效。方法 采集自体骨髓移植 Ｃ Ｄ３４ ＋ 造血干细胞，预处理用环磷酰胺（ Ｃ Ｔ Ｘ）６０ ｍｇ／ｋｇ 连续２ 天静滴，马法兰１４０ ｍｇ／ｍ ２ 分次口服，用格拉诺赛特（ Ｇ Ｃ Ｓ Ｆ） 刺激粒细胞的恢复，用间接免疫荧光法检测抗核抗体、放免法测抗 Ｄ Ｎ Ａ 抗体、流式细胞仪测淋巴细胞亚群，观察 Ａ Ｂ Ｍ Ｓ Ｃ Ｔ 前后临床表现和免疫学指标的变化。结果 Ａ Ｂ Ｍ Ｓ Ｃ Ｔ 后患者的临床症状明显缓解，异常免疫学指标恢复正常，抗体全部转阴。结论 Ａ Ｂ Ｍ Ｓ Ｃ Ｔ 对 Ｓ Ｌ Ｅ 有较好的疗效，远期疗效还需长期随访。

Objective To investigate therapeutic effect of autologous bone marrow stem cell transplantation (ABMSCT) on sytemic lupus erythematosus (SLE).Methods Transplantation of haematopoietic stem cell CD34 + acquired by autologous marrow aspiration was adopted.The conditioning before transplantation consisted of 60 mg/kg intravenous cyclophosphamide (CTX) for two days and 140 mg/m 2 oral maphalan.Granulocyte recovery was stimulated by G CSF.Indirect immunofluorescent and radioimmunologic tests used to examine ANA and anti DNA.Lymphocyte subset was analyesd by flow cytometry.Both clinical manifestations and immunologic markers were compared before and after transplantation. Results An excellent clinical and immunologic remission was observed post transplant and immunologic abnormality returned to normal.All antibodies were nagtivisation.Conclusion The therapy of autologous ABMSCT for SLE is remarkably effective.It is required to follow up for evaluation long effect.