异基因外周血造血干细胞移植治疗急性再生障碍性贫血——一例报告附文献复习  

Treatment of acute aplastic anemia with allogeneic peripheral blood stem cell transplantation: a case report and literature review

作　　者：赵晓武[1] 符粤文[1] 彭晓景[1] 陈蕾[1] 董秀娟[1] 侯天德[1] 谷景棉[1] 

机构地区：[1]郑州市第三人民医院,郑州骨髓移植中心,450000

出　　处：《中华血液学杂志》2001年第10期536-538,共3页Chinese Journal of Hematology

摘　　要：目的　探索异基因外周血造血干细胞移植治疗急性再生障碍性贫血 (再障 )的疗效及其长期造血重建。方法　 1例急性再障患者 ,30岁 ,供者为其胞弟 ,HLA配型完全相合。动员方案 :G CSF 2 5 0 μg/d× 6d。预处理方案 :环磷酰胺 (CTX) 5 0mg·kg-1·d-1× 4d ,抗胸腺细胞球蛋白 (ATG)2 0mg·kg-1·d-1× 2d ,移植有核细胞数MNC 8.97× 10 8/kg ,CD3 4+ 细胞 9.2 0× 10 6/kg ,CFU GM11.2 0× 10 5/kg。结果　移植后 18天造血重建。三个微卫星位点PCR监测显示移植后 18天为混合型嵌合 ,2 5天后为持续完全供者型嵌合。未发生急、慢性移植物抗宿主病 (GVHD) ,随访 2 40d血常规、骨髓象正常。结论　异基因外周血造血干细胞移植可有效治疗急性再障 ,本例造血重建迅速 。Objective To report a patient with acute aplastic anemia(AA) successfully treated with allogeneic peripheral blood stem cell transplantation(allo PBSCT).Methods A 30 years old patient with AA received allo PBSCT from a HLA compatible sibling donor. PBSCs mobilization regimen was G CSF 250?μg/d×6. The conditioning regimen included (CTX 50 mg·kg -1 ·d -1 )×4 and (ATG 10 mg·kg -1 ·d -1 )×2. 8.97×10 8 nucleated cells/kg, 9.20×10 6 CD 34 + cells/kg, 11.20 ×10 5 CFU GM/kg were transplanted. Results Hematopoietic reconstitution obtained on day 18 after allo PBSCT. Monitoring of engraftment with three microsatellite markers showed mixed chimerism on day 18 and complete chimerism after day 25. No acute or chronic graft versus host disease (GVHD) occurred. In the follow up duration of 240 days, the blood and bone marrow pictures were normal and the living status was good. Conclusion Allo PBSCT was an effective therapy in the treatment of acute aplastic anemia.

关 键 词：急性再生障碍性贫血 异基因外周血 造血干细胞移植 治疗 病例报告 

分 类 号：R556.5[医药卫生—血液循环系统疾病]