非清髓性自体外周血造血干细胞移植治疗系统性红斑狼疮远期疗效分析  

Nonmyeloablative autologous peripheral blood stem cell transplantation for systemic lupus erythematosus:5-year follow-up

作　　者：徐景勃[1] 钟淑萍[1] 庞文正[1] 谢锋[1] 李学刚[1] 何志国[1] 侯丽君[1] 

机构地区：[1]中山大学附属第五医院血液风湿科,广东珠海519000

出　　处：《中国实用内科杂志》2011年第10期783-784,共2页Chinese Journal of Practical Internal Medicine

基　　金：珠海市科技局科技计划项目(PC20041041)

摘　　要：目的探讨非清髓性自体外周血造血干细胞移植(NAST)治疗系统性红斑狼疮(SLE)的远期疗效。方法总结中山大学附属第五医院2002年11月至2005年10月4例成功接受NAST的SLE患者移植后的随访情况。非清髓性预处理移植前1～2 d静脉滴注阿糖胞苷200 mg/(kg.d)及环磷酰胺40 mg/(kg.d)。评价患者移植前后的相关症状体征、远期并发症及免疫功能的变化。结果白细胞总数恢复正常的中位时间12 d,血小板>100×109/L的中位时间为10 d,血红蛋白>120 g/L的中位时间为22 d。随访中,NAST后4例患者临床症状和体症均消失,淋巴细胞亚群检测显示:CD4+及CD4+/CD8+均恢复正常。1例男性患者移植4年后妻子正常受孕并产下一健康女婴。3例女性均恢复正常工作与生活。结论 NAST造血重建快,远期疗效确切。SLE患者NAST治疗后生活质量较好。Objective To evaluate the long-term efficacy of nonmyeloablative autologous peripheral blood stem cell transplantation （NAST） on systemic lupus erythematosus （SLE）. Methods Long-term follow up data of 4 SLE cases underwent NAST in the Fifth Affiliated Hospital, SUN Yat-Sen University during November 2002 and October 2005 was analyzed. The pretreatment regimen was intravenous injection of cytarabin [ 200 rag/ （ kg ·d）, - 2 - - 1 d ] and cyclophosphamide [ 40 rag/（ kg · d）, - 2 - - 1 d ]. The changes of symptoms, long term complications and immunological function before and after transplantation were evaluated. Results The median time for the total white blood cell recovery was 12 d. Median time for PLT 〉 100 × 10^9/L was 10 d,and that for HGB 〉 120 g/L was 22 d. During follow-up,clinical symptoms and signs in all the 4 cases disappeared. Lymphocyte subtype analysis showed that count of CD4 ＋ and the ratio of CD4^ ＋/CD8^ ＋ returned to normal. Wife of one i male patient was pregnant and gave birth to a healthy baby girl four years later after transplantation. Other three females also returned to normal life. Conclusion NAST owns a rapid hematopoietic recovery and is long-term effective. SLE patients treated with NAST enjoyed a good life quality.

关 键 词：系统性红斑狼疮 自体外周血造血干细胞移植 

分 类 号：R593.241[医药卫生—内科学]