摘要
目的 :研究自体造血干细胞移植治疗血液系统恶性肿瘤过程中环孢素A(CSA)能否诱导移植物抗宿主病(GVHD) ,并确定其毒副反应。方法 :进行自体造血干细胞移植的 10例血液系统恶性肿瘤患者接受CSA静脉滴注1.5mg/ (kg·d) ,0～ 2 8d ,观察皮疹情况、有无腹泻及血清胆红素水平来判断GVHD的发生 ;同时观察移植后造血重建、感染、出血以及检测肝、肾功能来分析其治疗的毒副反应。结果 :2例次早期出现GVHD ,皮疹为 +和 + + ,出现时间分别为移植后 8和 17d ,持续时间较短 ( 4和 5d) ,外周血WBC计数分别为 0 .9× 10 9/L和 0 .2× 10 9/L ;6例次患者出现GVHD皮疹 ( 1例 + ,5例 + + ,不包括前述 2例次 )的时间为 30d( 2 2～ 4 4d) ,皮疹持续时间为 18d( 9～ 2 8d) ,外周血WBC计数为 1.4 5× 10 9/L[( 0 .4～ 2 .6 )× 10 9/L]。对移植后造血重建、感染、出血 ,以及肝、肾功能的影响不明显。结论 :CSA在自体造血干细胞移植过程中可以安全地诱导GVHD的发生 。
Objective:To investigate if graft_ versus _host disease(GVHD) could be induced by treatment with cyclosporine A(CSA) in patients undergoing autologous hematopoietic stem cell transplantation for hematological malignancies, and define the toxicities of this approach. Methods: Ten cases of hematological malignancies were administrated with intravenous CSA 1.5?mg/(kg·d) 0-28?d following autologous stem cell transplantation.Induction of GVHD was monitored by rashes, diarrhea and jaundice.Toxicities of treatment were assessed by analysis of hematopoietic reconstitution, infection, hemorrhage, hepatic and renal function after_transplantation. Results:GVHD was early induced in 2 cases at 8d and 17?d after transplantation respectively; Rashes were graded + and ++, lasted 4 and 5?d; WBC counts were 0.9×10 9/L and 0.2×10 9/L at onset of GVHD. GVHD of the skin occurred in 6 cases except 2 cases mentioned above(1 case +, 5 cases ++) at 30?d(22-44?d) and lasted 18?d(9- 28?d) ; WBC counts were 1.45×10 9/L[(0.4-2.6)×10 9/L] at onset of GVHD. No negative impact on hematopoietic reconstitution, infection, hemorrhage, hepatic and renal function after transplantation was observed.Conclusions:GVHD can be safely induced by treatment with CSA in patients undergoing autologous hematopoietic stem cell transplantation for hematological malignancies. Further investigation is needed for evidence of antitumor efficacy.
出处
《军事医学科学院院刊》
CSCD
北大核心
2003年第2期128-130,共3页
Bulletin of the Academy of Military Medical Sciences
