异基因造血干细胞移植治疗骨髓增生异常综合征：适应证及移植前是否需化疗  

Allogeneic hematopoietic stem cell transplantation for myelodysplastic syndrome： indications and controversy of pre-transplant chemotherapy

作　　者：刘代红[1] 

机构地区：[1]北京大学血液病研究所北京大学人民医院血液科,100044

出　　处：《白血病．淋巴瘤》2013年第6期341-343,共3页Journal of Leukemia & Lymphoma

摘　　要：异基因造血干细胞移植（allo．HSCT）治疗骨髓增生异常综合征（MDS）的适应证以FAB分型、国际预后评分系统（IPSS）、世界卫生组织预后评分系统（WPSS）为基础，IPSS中危-2及高危的患者应尽可能在诊断早期接受移植；中危-1及以下者将从延迟移植中受益。临床决策中应动态随诊病情变化、及时把握疾病状态及进展速度适时移植。中低危患者血小板极低、中性粒细胞缺乏或输血依赖重者应尽早移植。MDS中高危患者移植前是否该应用去甲基化药物或化疗尚存争议，迄今临床研究数据表明移植前化疗对移植预后无益。The indications for myelodysplastic syndrome （MDS） to receive allogeneic hematopoietic stem cell transplantation （allo-HSCT） were established on the basis of FAB diagnosis, International Prognosis Scoring System （IPSS） and World Health Organization Prognosis Scoring System （WPSS）. It was recommended that patients of IPSS intermediate risk II and of high risk should receive allo-HSCT at diagnosis, and those with intermediate risk I and of low risk might benefit from deferred transplantation. Dynamic monitoring of marrow morphology and the risk of disease are needed for appropriate timing of transplant. Patients of intermediate risk and low risk with low platelet count, pneutropenia or blood infusion dependence are indicated for transplantation. The advantage of chemotherapy pre-HSCT in those indicated patients has been controversial. Up to now, there has been few data showing benefit of pre-chemotherapy or hypomethylating therapy.

关 键 词：骨髓增生异常综合征 造血干细胞移植 异基因 化疗 

分 类 号：R5[医药卫生—内科学]