自体外周血干细胞联合自体骨髓移植与单纯自体骨髓移植后造血功能重建的比较

Comparison of hematologic recovery between autologous peripheral blood stem cell plus bone marrow transplants and simple autologous bone marrow transplant

目的 :比较自体外周血干细胞联合自体骨髓移植 (APBSCT +ABMT)与单纯自体骨髓移植 (ABMT)后造血功能重建及有关临床指标。方法 :以 10例APBSCT +ABMT及 10例ABMT病人作为研究对象。结果 :移植后APBSCT +ABMT组与ABMT组白细胞 >1.0× 10 9·L 1、中性粒细胞 >0 .5× 10 9·L 1和血小板 >5 0× 10 9·L 1的中位数时间分别为 10、11、13d和 15、17、2 0d(均为P <0 .0 5 )。输血浆量及血小板量APBSCT +ABMT组明显较ABMT组为少 (P <0 .0 1)。伊米配能使用率ABMT组明显高于APBSCT+ABMT组 (P <0 .0 1)。出血发生率及程度两组均有显著差异 (P <0 .0 5 )。住层流病房时间APBSCT +ABMT组明显较ABMT组短 (P <0 .0 1)。但血红蛋白下降程度两组无显著差异 (P >0 .0 5 )。结论 :APBSCT +ABMT可加快造血功能重建速度 ,并降低严重感染和出血的发生率 ,减少血液成分输注及抗生素的使用 ,缩短住院时间 ,同时可利用骨髓进行体外净化 ,因此仍不失为一种治疗恶性肿瘤的有效手段。

Objective[WT5BZ]:To compare the speeds of engraftment and concerning clinical data between autologous peripheral blood stem cell plus bone marrow transplants (APBSCT+ABMT)and simple autologous bone marrow transplant(ABMT).[WT5HZ]Methods:[WT5BZ]APBSCT+ABMT( n =10) and ABMT( n =10) were used on the treatment of acute leukemia and lymphoma patients,their data were studied.[WT5HZ]Results:[WT5BZ]The average days reach WBC>1.0×10 9·L 1 ,N>0.5×10 9·L 1 and Plt>50×10 9·L 1 were 10,10.5,12.5 in APBSCT+ABMT group and 15,17,24 in ABMT group respectively( P <0.05).There was a significant decrease in the number of plasma and platelets transfusions in the APBSCT+ABMT group as compared with ABMT group( P <0.01).The rate of Tienam use was significantly greater in ABMT group than in APBSCT+ABMT group( P <0.05, P <0.01).There was a significant difference about the rate and degree of bleeding between these two groups ( P <0.05),and also a significant shorting of living in laminar air flow bioclean room in APBSCT+ABMT group than in ABMT group ( P <0.01).No difference was seen between two groups about reducing of hemoglobin and the number of red blood cells transfusion( P >0.05).[WT5HZ]Conclusion:[WT5BZ]APBSCT+ABMT can improve the rate of hematologic recovery,and thus,decrease the rate of infection,bleeding,transfusion,antibiotics usage and length of hospitalization,it is an effective therapy for malignancies.