自体骨髓间充质干细胞联合造血干细胞移植治疗系统性红斑狼疮  

Combined Mesenchymal Stem Cells with Blood Stem Cell Transplantation for Lupus Erythematosus Autologous Peripheral Treatment of Systemic

作　　者：黄振倩[1] 谭获[1] 王春燕[1] 张还珠[1] 刘丹[1] 李海明[1] 周承志[1] 郑润辉[1] 刘芳[1] 刘芯[1] 项鹏[2] 

机构地区：[1]广州医学院第一附属医院肿瘤血液中心,广东广州510230 [2]中山大学干细胞研究中心,广东广州510080

出　　处：《国际医药卫生导报》2007年第24期14-17,共4页International Medicine and Health Guidance News

摘　　要：目的探讨间充质干细胞（MSC）联合自体造血干细胞移植（HSCT）治疗系统性红斑狼疮（SLE）的安全性、疗效和对造血重建的影响。方法采用无血清体系培养扩增骨髓MSC，联合APBSCT治疗1例SLE。干细胞动员应用异环磷酰胺（IFO）7g／m^2，分两天应用和粒细胞集落刺激因子（G-CSF）5-10μg／kg·d^-1；预处理方案包括氟达拉滨（30mg／m^2·d^-1，-6、-5、-4、-3、-2d），抗胸腺细胞球蛋白（ATG15mg／kg·d^-1，-3、-2、-1、0、＋1d）。结果患者获得造血重建，中性粒细胞〉0．5×10^9／L的时间是＋4d，血小板未〈20×10^9／L；SLE的临床表现明显减轻，尿蛋白消失，自身抗体转阴，泼尼松用量〈10mg／d。结论MSC联合APBSCT治疗SLE近期疗效显著，造血重建恢复迅速，安全有效，远期疗效尚需进一步观察。Objective To investigate the efficacy and safety of combined mesenchymal stem cells （MSC） with autologous peripheral blood stem cell transplantation （APBSCT） in treatment of systemic lupus erythematosus （SLE）. Methods One patient with SLE received MSC-APBSCT. Bone marrow MSCs were incubated and proliferated under serum free culture media. Peripheral stem cells were mobilized with IFO （7g/ m^2） and G-CSF （5-10 μg/kg · d^-1）. Conditioning regimen consisted of Fludara（30 mg/ m^2· d^-1, -6d, -5d, -4d, -3d, -2d） plus antithymocyte globulin（ATG 15 mg/kg · d^-1, - 3d, -2d, -1d, 0d, ＋1d,）. Results The hematopioetic reconstitution of the patient was successful after APBSCT. The time for granulocyte count〉0. 5 × 10^9/L was 4 days, and for platelet no less than 20 × 10^9/L. The clinical manifestations of the patient improved obviously after transplantation. The proteinuria decreased or disappeared, and the autoantibodies decreased or became negative. The dosage of prednisone was less than 10 mg/d. Conclusion MSC-APBSCT for SLE shows remarkable short-term effect. Hematopoietic reconstitution soon recover. It is safe and effective, but the long-term effects have to be observed.

关 键 词：系统性红斑狼疮 造血干细胞移植 间充质干细胞 

分 类 号：R593[医药卫生—内科学]