自体外周血干细胞移植治疗难治性系统性红斑狼疮的临床研究  

A clinical study on the treatment of systemic lupus erythematosus with autologous peripheral blood stem cell transplantation

作　　者：蓝梅[1] 林金盈[1] 李永敢[1] 任咏薇[1] 韦美秋[1] 朱霞[1] 曾维平[1] 黄玉葵[1] 伍秋霞[2] 龚智峰[2] 

机构地区：[1]广西壮族自治区人民医院血液/风湿科,南宁530021 [2]广西壮族自治区人民医院泌尿内科,南宁530021

出　　处：《内科》2007年第6期875-877,共3页Internal Medicine

基　　金：广西卫生厅自筹课题项目(Z2005127)

摘　　要：目的探讨自体外周血干细胞移植(APBSCT)治疗难治性系统性红斑狼疮(SLE)的临床疗效。方法对难治性SLE患者进行APBSCT治疗。采用环磷酰胺(CTX)+粒细胞集落刺激因子(G-CSF)方案动员,CS-3000血细胞分离机采集外周血干细胞并保存于-80℃冰箱;用CTX50mg/(kg.d)×3～4d方案预处理后,解冻后回输冻存的干细胞的治疗方法。观察APBSCT前后临床表现及免疫学指标的变化。结果动员后获得单个核细胞数(MNC)(3.383～3.704)×108/kg;CD34+细胞数(4.4～11.12)×106/kg。3例均获得造血重建,中性粒细胞>0.5×109/L、血小板>20×109/L的中位数时间分别是8.3d、10d。移植后患者临床症状消失,1例并肾功能不全、难治性高血压和重度贫血的患者移植后恢复正常。3例患者自身抗体转阴或滴度减低,尿蛋白定性消失,SLE疾病活动指数(SLE-DAI)由移植前的平均15分下降为移植后6个月的平均4分。结论APBSCT治疗难治性SLE安全有效,近期疗效好,远期疗效有待进一步观察。Objective To investigate the efficacy of autologous peripheral blood stem cell transplantation（APBSCT） in treatment of refractory systemic lupus erythematosus（SLE）. Methods The patients with refractory SLE received APBSCT. Peripheral stem cells were. mobilized with CTX plus G-CSF and were collected with CS-3000 cell separator and preserved in -80℃ icebox;Preparative regimen was CTX 50 mg/kg·d×3 -4 d;Peripheral blood stem cells were defrosted and reinfused. Both clinical manifestations and immunologic markers were compared before and after transplantation. Results （3. 383 - 3. 704）×10^8/kg MNC and （4.4 - 11.12 ）×10^6/kg CD34^＋ cell were obtained. The hematopoietic reconstitution of the 3 patients was successful after APBSCT. The median time for granulocyte count 〉0.5×10^9/L was 8.3 days and for platelet 〉 20×10^9/L was 10 days. The clinical manifestations of the patients disappeared, 1 patients was recovered from renal failure and refractory hypertension and serious anemia after transplantation. All three patients hutoantibodies decreased or became negative, proteinuria disappeared,and SLE-DAI score decreased from 15 to 4 after 6 months. Conclusion APBSCT for treatment of refractory SLE is safe,the short-term effects are remarkable, but the long-term effects have to be observed.

关 键 词：造血干细胞移植 外周血 系统性红斑狼疮 

分 类 号：R593.241[医药卫生—内科学]