抗CD25单克隆抗体治疗耐激素的急性移植物抗宿主病疗效分析  

Efficacy of Anti-CD25 Monoclonal Antibody Used in Treating Steroid-Resistant Acute Graft-versus-Host Disease Following Haploidentical Bone Marrow Transplantation

作　　者：刘静[1] 王恒湘[1] 段连宁[1] 阎洪敏[1] 薛梅[1] 朱玲[1] 丁丽[1] 王志东[1] 

机构地区：[1]空军总医院血液科,北京100036

出　　处：《中国实验血液学杂志》2009年第1期160-163,共4页Journal of Experimental Hematology

摘　　要：本研究探讨抗CD25单克隆抗体在单倍体相合骨髓移植术(hiBMT)后耐激素的急性移植物抗宿主病(aGVHD)治疗中的作用。对15例单倍体相合BMT后出现耐激素的Ⅱ-Ⅳ度aGVHD的患者给予巴利昔单克隆抗体20 mg,第1、4天静脉点滴,未达到疗效的病人间隔1周后重复本治疗。结果显示:完全有效8例(53.33%),其中4例无病生存,2例生存伴局限性cGVHD,2例死于肺部感染;3例部分有效(20%),其中1例无病生存,1例死于aGVHD及感染,1例死于肺部感染;4例无效(26.67%)死亡,死亡原因有GVHD、肺部感染、心力衰竭。总有效率73.33%,总生存率46.67%。该药应用安全,未发现输注相关的毒副作用。结论:抗CD25单克隆抗体对单倍体相合BMT后耐激素的Ⅱ-Ⅳ度aGVHD具有较好的疗效,但总的生存率仍然较低,感染仍然是导致该类患者死亡的主要原因,因此加强环境保护,预防感染极为重要。The aim of this study was to investigate the efficacy and feasibility of anti-CD25 monoclonal antibody （basiliximab） in treating steroid-refractory acute graft-versus-host disease （aGVHD） following haploidentical bone marrow transplantation （hiBMT）. 15 cases who developed Ⅱ-Ⅳ grade steroid-resistant aGVHD after haploidentical BMT were treated by intravenous injection of basiliximab at a dose of 20 mg on days 1 and 4. In those patients not achieving CR after 1 week, basiliximab injection was repeated. The results showed that 8 cases （53.33%） got complete response （CR）. Out of them 4 cases have been still in disease-free survival, 2 cases have been in survival with limited cGVHD, 2 cases died from pulmonary infection; 3 cases（65%） got partial response （PR）, out of whom 1 case has been still in disease-free survival, one died from GVHD and infection, and another one died from pulmonary infection; 4 cases without response died from GVHD, pulmonary infection and cardiac failure. Overall response rate was 73.3 % and long-term survival rate was 46. 7%. There were no infusion-associated side-effects after treatment with basiliximab. It is concluded that the anti-CD25 monoclonal antibody is efficacious and feasible for steroid-refractory grade Ⅱ-Ⅳ aGVHD after hiBMT, but the overall survival rate is low. Infection is the main cause of death. Thereby, it is especially important to strengthen environmental orotection and orevent infection.

关 键 词：抗CD25单克隆抗体 骨髓移植 急性移植物抗宿主病 巴利昔 

分 类 号：R457.7[医药卫生—治疗学]