硼替佐米联合利妥昔单抗和血浆置换治疗高致敏等待肾移植患者

背景:高致敏是肾移植成功的障碍,目前肾移植脱敏治疗方法有静注免疫球蛋白、血浆置换、兔抗人淋巴细胞球蛋白等,但治疗效果常不满意。目的:通过利妥昔单抗和硼替佐米进行肾移植后脱敏治疗,寻求效果满意的治疗方案。方法:1例高致敏等待肾移植患者接受脱敏治疗,接受血浆置换2次后,立即给予利妥昔单抗500mg静滴,2d后开始分别在第1,4,8,11天给予硼替佐米1.3mg/m2,随访观察群体反应性抗体等变化。结果与结论:随访的9个月中,患者群体反应性抗体从92%下降到17%,患者对利妥昔单抗和硼替佐米有良好的耐受性。初步经验表明:硼替佐米联合利妥昔单抗和血浆置换三联脱敏治疗方案可快速持久降低循环抗体水平,硼替佐米可能成为脱敏治疗方案中的重要要素。

CTA制剂对兔耳痒螨的治疗效果和作用机理研究

本文评价“蜱螨类寄生虫抗原注射液”（下简称ＣＴＡ）制剂对兔耳痒螨病的治疗效果。结果表明：对自然感染兔耳痒螨试验组，第１天和第１４天分别使用ＣＴＡ制剂，３周后螨虫消失，且直至试验结束无复发。试验组兔Ｂ淋巴细胞数量和ｒ－球蛋白含量分别比对照组增高４９．９３％和１２４．１３％；比自然感染兔耳痒螨的螨虫对照组分别增高３３．５４％和４４．１０％。本文还对ＣＴＡ制剂杀灭螨虫的免疫机制进行了探讨。

An addition of medium-dose ATG to conditioning regimens favours the long-term survival of patients with allogeneic hematopoietic stem cell transplantation

Long-term survival of 116 leukemia/MDS patients received allo-SCT conditioned by a regimen with ATG-F or without ATG-F was analysed, together with the impact of ATG-F on the long-term survival, GVHD and disease relapse. Seventy patients received an ATG-F containing conditioning regimen FBCA, and 46 patients received a non-ATG-F FBC regimen. The FBCA regimen was associated with a 5-year survival of 65.4% in the complete HLA-matched group and 39.3% in the HLA-mismatched group. The difference between the two groups was significant (P = 0.012). For the FBC conditioning regimen, the 5-year overall survival of HLA-matched patients and the HLA-mismatched patients was 34.2% and 24.2% respectively (P = 0.216). The incidence of cGVHD was 32.9% and 83.6% in the FBCA and FBC condition regimen group respectively. Only 2.9% of the cases showed extensive cGVHD in the FBCA group while it was 69.4% in the FBC group (P = 0.00). Multivariate analysis indicated that relapse was related to the disease status and HLA typing, but unrelated to the conditioning regimens whether or not ATG-F was used (HR 0.54, P = 0.109). We conclude that the addition of ATG-F to conditioning regimen favours the longterm survival of allo-SCT.