外周血干细胞移植治疗难治性系统性红斑狼疮

Treatment of systemic lupus erythematosus with autologous peripheral blood stem cell transplantation

目的 观察自体外周血干细胞移植 (APBSCT)治疗难治性系统性红斑狼疮 (RSLE)的疗效及安全性。方法 RSLE 3例 ,先给予血浆置换、环磷酰胺 (CTX)和大剂量丙种球蛋白 ,然后用环磷酰胺和粒细胞集落刺激因子 (G CSF)动员造血干细胞 (HSC) ,多功能加强型血细胞分离机采集外周血干细胞 ,-86℃超低温冻存 ,环磷酰胺预处理 ,经静脉回输干细胞 ,最后应用抗胸腺淋巴细胞球蛋白 (ATG)行体内去T淋巴细胞。观察移植前后临床症状、体征和免疫学指标的变化。结果 APBSCT后患者的临床症状完全缓解 ,异常免疫学指标基本恢复正常 ,抗体全部转阴。结论 APBSCT对难治性系统性红斑狼疮有明显的疗效 ,尤其适用对各种药物治疗无效的患者 。

Objective To explore the clinical effect of autologous peripheral blood stem cell transplantation (APBSCT) on refractory systemic lupus erythematosus (RSLE).Methods Three cases with RSLE were employed.The patients were firstly given plasma exchange,cyclophosphamide(CTX) and high dosage intravenous IgG; Peripheral blood stem cell(PBSCs) were activated with CTX and granulocyte colony stimulating factor(G CSF).The haematopoietic stem cells (HSCs) were harvested by continuous flow leukapheresis using a MCS+ blood separator.The cells were preserved at -86?℃. PBSCs were reinfused after conditioned by CTX (50?mg/kg),Granulocyte recovery was stimulated by G CSF.Antithymocyte globulin (ATG) was given in vivo for T cell depletion.Both clinical manifestations and immunologic markers were compared before and after transplantation.Results After transplantation the clinical remission was arrived and immunologic abnormality returned to negative.Conclusion APBSCT is effective and safe for RSLE. It is necessary to follow up for evaluating its long term effect.