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骨髓与造血干细胞移植 被引量:1

Bone Marrow and Stem Cells Transplantation
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摘要 骨髓移植(bone marrow transplata-tion,BMT)可分为同基因骨髓移植(syngeneic-BMT,简称 SYN-BMT),异基因骨髓与造血干细胞移植(allogeneic BMT/PBSCT,简称 Allo-BMT/PBSCT)及自体骨髓与造血干细胞移植(Autologous BMT,简称Auto-BMT/PBSCT)移植。其中 Allo-BMT/PBSCT 以其较广泛的适应证和优越的疗效在骨髓移植中占有重要的地位。Allo-BMT/PBSCT 首先要有与受者 HLA 配型相合的供者,符合条件的受者要先接受 BUCY 或 TBI+CY 预处理,再给病人经静脉输入供者骨髓或干细胞。对于 ABO 血型不合者,可先去除供者骨髓或干细胞中的红细胞,再经静脉输入。BMT 的合并症包括在BMT 前所进行的放、化疗的毒性反应,急性移植物抗宿病(acute graft-versus-host disease AGVHD),各种感染和原发病的复发。AML-CRI 期病人经 Allo-BMT后5年存活率达70%,Syn-BMT 是治疗重症再生障碍性贫血(severe aplastic anemia,SAA)的最佳选择。Au-to-BMT/PBSCT 多用于恶性肿瘤及其它实体瘤的治疗。 BMT/PBSCT includes syngeneic (from identi- cal twins),allogeneic (from an HLA-matched siblings or unrelated donors)or autologous (from the patient),here- after referred to as SYN-BMT.Allo-BMT is the most important because of its greater adaptability and excellent therapeutic effects.Having an HLA-matched donor is the first essential factor for allo-BMT.The recipient,condi- tioned with TBI+CY or BUCY regimen,must be infused with the harvested marrow cells intraverously before the BMT.Because of ABO incompatibility,the red cells must be removed one way or another before infusion.The com- plications of BMT include numerous kinds of toxicity of chemotherapy and radiation,GVHD,infections.Relapse of the original disease and secondary malignancies are rare. The 5 year survival in recipients with AML-CR1 is 70% afterallo-BMT.Syn-BMT is the therapy of choice for SAA,and Auto-BMT/PBSCT is frequently used for the treatment of malignant lymphoma and other solid tumors.
作者 陆道培
出处 《当代医学》 1997年第4期246-251,共6页 Contemporary Medicine
关键词 骨髓移植 造血干细胞移植 HLA 抗原 预处理方案 合并症 BMT/PBSCT HLA antigen conditioning regimen complication
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