期刊文献+
任意字段
题名或关键词
题名
关键词
文摘
作者
第一作者
机构
刊名
分类号
参考文献
作者简介
基金资助
栏目信息

非清髓异基因外周造血干细胞移植治疗重型再生障碍性贫血 被引量：3

下载PDF
导出
摘要 【目的】探讨非清髓性异基因造血干细胞移植(Allo-HSCT)治疗重型再生障碍性贫血(SAA)的近期疗效及其并发症。【方法】9例确诊的年轻SAA患者接受了同胞HLA全相合外周造血干细胞(PBSC)移植,预处理方案为:环磷酰胺(50mg·kg-1·d-1,移植前5d至移植前2d静滴)+兔抗人胸腺细胞球蛋白(antithymocyte globulin,2.5mg·kg-1·d-1,移植前5d至移植前3d静滴)。观察移植后临床造血重建时间及近期并发症,并于移植后40d、180d和360d用短小片段重复序列(STR)动态检测其植入情况。【结果】9例患者移植后中性粒细胞升至0.5×109/L的时间平均为14.5d、血小板升至20×109/L的时间平均为23.5d,移植后180d和360d的外周血象及骨髓象均恢复正常,移植后40d、180d和360dSTR显示9例均表现为完全嵌合体(FDC);所有病例中,有1例发生Ⅱ度急性移植物抗宿主病(aGVHD)、2例出现Ⅰ度aGVHD,2例发生局限性慢性GVHD;6例患者出现CMV血症,更昔洛韦治疗有效;1例发生念珠菌性肠炎、1例发生曲霉菌性肺炎和1例发生细菌性肺炎,抗真菌或细菌治疗后痊愈;3例患者出现口腔溃疡,1例患者出现出血性膀胱炎,未发现肝静脉闭塞病。所有患者目前均存活且在随访中。【结论】非清髓同胞Allo-HSCT造血重建快、植入率高且并发症少,是治疗年轻SAA患者的有效手段,但本研究中病例年龄轻、诊断到移植之间的时间短、血制品输注少,是移植成功的有利因素,在其他SAA的患者中能否取得良效还需更多临床验证。
作者 陈媚 邹外一 许多荣 童秀珍 彭爱华 李娟 罗绍凯 黄珊
机构地区 中山大学附属第一医院血液科
出处 《中山大学学报（医学科学版）》 CAS CSCD 北大核心 2008年第S1期53-56,共4页 Journal of Sun Yat-Sen University:Medical Sciences
基金 广东省科技计划项目(2004B30301003)
关键词 重型再生障碍性贫血 异基因造血干细胞移植 疗效 并发症
分类号 R556.5 [医药卫生—血液循环系统疾病]
  • 相关文献

参考文献13

  • 1童秀珍,邹外一,许多荣,李娟,罗绍凯,彭爱华,张国材,郑冬.异基因造血干细胞移植患者发生口腔黏膜炎的危险因素分析[J].中山大学学报（医学科学版）,2007,28(5):582-585. 被引量：11
  • 2黄科,黄绍良,方建培,钟凤仪,周敦华,李栋方,岑丹阳.强化免疫抑制治疗儿童再生障碍性贫血疗效分析[J].中山大学学报（医学科学版）,2004,25(5):486-488. 被引量：7
  • 3Hirohito Yamazaki,Chiharu Sugimori,Tatsuya Chuhjo,Shinji Nakao.Cyclosporine Therapy for Acquired Aplastic Anemia: Predictive Factors for the Response and Long-term Prognosis[J]. International Journal of Hematology . 2007 (3)
  • 4Feramura M,Kimura A,Iwase S,et al.Treatment of severe of aplastic anemia with antithymocyte globulin and cyclosporin A with or without G-CSF in adults:multicenter randomized study in Japan. Blood . 2007
  • 5George B,Mathews V,Viswabandya A,et al.Fludarabine and cyclophosphamide based reduced intensity conditioning(RIC)regimens reduce rejection and improve outcome in Indian patients undergoing allogeneic stem cell transplantation for severe aplastic anemia. Bone Marrow Transplantation . 2007
  • 6Young,NS,Calado,RT,Scheinberg,P.Current concepts in the pathophysiology and treatment of aplastic anemia. Blood . 2006
  • 7Yamaguchi H,Baerlocher GM,Lansdorp PM.Mutations of the human telomerase RNA gene (TERC) in aplastic anemia and myelodysplastic syndrome. Blood . 2003
  • 8Dincol G,Aktan M,Diz-K(u|¨)c(u|¨)kkaya R,et al.Treatment of acquired severe aplastic anemia with antilymphocyte globulin,cyclosporin A,methyprednisolone,and granulocyte colony-stimulating factor. American Journal of Hematology . 2007
  • 9Horowitz MM.Current status of allogeneic bone marrowtransplanta-tion in acquired aplastic anemia. Seminars in Hematology . 2000
  • 10Anderson D,Ali K,Blanchette V,et al.Guidelines on the use of intravenous immune globulin for hematologic conditions. Transfusion Medicine Reviews . 2007

二级参考文献17

  • 1Nakao S. Immune mechanism ofaplastic anemia[J]. Int J Hematal,1997,66(2):127-34.
  • 2Rosenfeld S J, Kimball J, Vining D, et al. Intensive immunosuppression with antithymocyte globulin and cyclosporine as treatment for severe acquired aplastic anemia[J]. Blood, 1995,85(1):3058-65.
  • 3Kojima S, Hibi S, Kosaka Y, et al. Immunosuppressive therapy using antithymocyte globulin, cyclosporine, and danazol with or without human granulocyte colonystimulating factor in children with acquired aplastic anemia[J]. Blood, 2000,96(6):2049-54.
  • 4VERA-LIONCH M, OSTER G, FORD C M, et al. Oral mucositis and outcomes of allogeneic hematopoietic stemcell transplantation in patients with hematologic malignancies [J].Support Care Cancer,2007,15(5):491-496.
  • 5KEEFE D M,SCHUBERT M M,ELTING L S, et al. Updated clinical practice guidelines for the prevention and treatmentofmucositis [J]. Cancer, 2007,109(5): 820-831.
  • 6WOO S B, SONIS S T, MONOPOLI M M, et al . A longitudinal study of oral ulcerative mucositis in bone marrow transplant recipients [J]. Cancer, 1993,72 (5): 1612-1617.
  • 7GORI E, ARPINATI M, BONIFAZI F, et al. Cryotherapy in the prevention of oral mucositis in patients receiving low-dose methotrexate following myeloablative allogeneic stem cell transplantation: a prospective randomized study of the Gruppo Italiano Trapianto di Midollo Osseo nurses group [J]. Bone Marrow Transplant, 2007,39(6):347-352.
  • 8ROBIEN K, SCHUBERT M, BRUEMMER B, et al. Predictors of oral mucositis in patients receiving hematopoietic cell transplants for chronic myelogenous leukaemia[J]. J Clin Oncol, 2004, 22(7): 1268-1275.
  • 9BOLWELL BJ, KALAYCIO M, SOBECKS R, et al. A muhivariable analysis of factors influencing mucositis after autologous progenitor cell transpantation Bone marrow transpation [J]. 2002,30(9):587-591.
  • 10RAPOPORT A P, MILLER WATELET L F, LINDER T, et al. Ananlysia of factors that correlate with mucositis in recipients of autologous and allogeneic stem-cell transplants [J]. J Clin Oncol,1999,17(8):2446-2453.

共引文献16

同被引文献36

  • 1MARSH J C, BALL S E, CAVENAGH J, et al. Guidelines for the diagnosis and management of aplas- tic anaemia[J]. Br J Haematol, 2009,147 4a-- 70.
  • 2MAURY S,BAL6RE-APPERT M L,CHIR Z,et al. Unrelated stem cell transplantation for severe ac- quired aplastic anemia: improved outcome in the era of high-resolution HLA matching between donor and recipient[J]. Haematologica, 2007,92 : 589 ---596.
  • 3DEEG H J, O'DONNELL M, TOLAR J, et al. Optimization of conditioning for marrow transplantation from unrelated donors for patients with aplastic ane- mia after failure of immunosuppressive therapy[J]: Blood, 2006,108 : 1485-- 1491.
  • 4KANG H J,SHIN H Y,PARK J E,et al. Successful engraftment with fludarabine, cyclophosphamide, and thymoglobulin conditioning regimen in unrelated transplantation for severe aplastic anemia:A phase 1] prospective multicenter study[J]. Biol Blood Marrow Transplant, 2010,16 = 1582-- 1588.
  • 5KUMAR R, PREM S, MAHAPATRA M, et al. Flu- darabine, cyclophosphamide and horse antithymocyte globulin conditioning regimen for allogeneic peripheral blood stem cell transplantation performed in non-HE- PA filter rooms for multiply transfused patients with severe aplastic anemia[J].Bone Marrow Transplant, 2006,37:745--749.
  • 6RESNICK I B, AKER M, SHAPIRA M Y, et al. Allo- geneie stem cell transplantation for severe acquired aplastic anaemia using a fludarabine-based preparative regimen[J]. Br J Haematol, 2006,133 : 649- 654.
  • 7GEORGE B, MATHEWS V, VISWABANDYA A, et al. Fludarabine and cyclophosphamide based reduced intensity conditioning(RIC) regimens reduce rejection and improve out-come in Indian patients undergoing allo-geneic stem cell transplantation for severe aplastic anemia[l]. Bone Marrow Transplant, 2007,40 : 13 --18.
  • 8GEORGE B, MATHEWS V, VISWABANDYA A, et al. Fludarabine based reduced intensity conditioning regimens in children undergoing allogeneic stem cell transplantation for severe aplastic anemiaFJ. Pediatr Transplant, 2008,12 : 14-- 19.
  • 9MAURY S, BACIGALUPO A, ANDERLINI P, et al. Improved outcome of patients older than 30 years receiving HLA-identical sibling hematopoietic stem cell transplantation for severe acquired aplastic anemia u- sing {ludarabine-based conditioning: a comparison with conventional conditioning regimen[J]. Haemato- logica, 2009,94 : 1312-- 1315.
  • 10BACIGALUPO A,SOCIE' G, LANINO E, et al. Flu- darabine, cyclophosphamide, antithymocyte globulin, with or without low dose total body irradiation, for al- ternative donor.transplants,in acquired severe aplastic anemia: a retrospective study from the EBMT-SAA working party [J]: Haematologica, 2010, 95:976 -- 982.

引证文献3

二级引证文献3

中山大学学报（医学科学版）
2008年 第S1期

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部