自体外周血造血干细胞移植后免疫功能重建的探讨

THE IMMUNITY RECONSTRUCTION IN AUTOLOGOUS PERIPHEREL BLOOD STEM CELL TRANSPLANT RECIPIENTS

目的 :探讨自体外周血造血干细胞移植后细胞免疫功能的重建与并发症、疗效的关系。方法 :14例淋巴瘤 (NHL 11例、HD3例 )、1例多发性骨髓瘤 (MM)、1例小细胞肺癌 (SCL C) ,16例患者均属 期～ 期。监测移植前、移植后 2 0天的细胞免疫功能 ,并分析与免疫相关的并发症。结果 :细胞免疫功能指标 T3 、T4、T8、NK活性+2 0天左右恢复至移植前水平。移植后 s IL - 2 R平均水平未恢复正常。有 2例患者± 6 0天并发带状疱疹 ,均与移植前细胞免疫功能低下 ,移植后不能快速恢复正常 ,且移植前病程均 >中位数 16月有关。结论 :要疗效好且减少与免疫相关并发症宜在 CR后 2月～ 6月时进行移植 。

Objective:To explore the relationship of reconstruction of immumity,complication and curative effection after autologous Peripherel blood stem cell transplantation(APBSCT).Methods:Sixteen patients at stage Ⅱ-Ⅳ were included in the study:14 patients with lymphoma in which 11 were Non Hodgkin's lymphoma(NHL) and 3 were Hodgkin's Disease(HD),and 1 with malignent mylenoma(MM),1 with small cell lung cancer (SLCL).The patients immunity before APBSCT and after transplantation for 20 days was detected,and the complication was analysed.Rusults:The T 3?T 4?T 8?NK activity recovered to the level before APBSCT,but sIL 2R level remained abnormal.Two patients had complication of herpes zoster or herpers encephalitis after APBSCT for about 60 days because of lower immunity.Their therapy course were longer than 16 months.Conclusion:If we want to obtain good curable effetion and decrease the complication correlating immunity,APBSCT should be given between 2-6 months after complete remision,and the immunization schedule was proposed for the patients undergoing APBSCT.