自体外周血造血干细胞移植治疗系统性红斑狼疮9例临床疗效探讨  

The explore of the clinical effect for treatment of 9 SLE cases by autologous perpheral blood stem cells transplantation

作　　者：张雷[1] 马红霞[2] 冯冬梅[1] 孙评[1] 张玉红[1] 张伟[1] 李建斌[1] 

机构地区：[1]河南省红十字血液中心,郑州450053 [2]郑州市第三人民医院血液科

出　　处：《河南医药信息》2002年第1期1-3,共3页Henan Medical Information

摘　　要：目的 :探讨自体外周血造血干细胞移植 (Autologousperipheralbloodstemcellstransplantation ,ABSCT)治疗系统性红斑狼疮 (SLE)的临床效果。方法 :选择 9例SLE患者 ,应用BaxterCS - 30 0 0plus连续血流式血细胞分离机进行自体外周血造血干细胞采集。预处理方案 :分次全淋巴照射 (TLI) 12 - 16Gy ,环磷酰胺 5 0mg/kg(- 3,- 2 ,- 1d) ,ATG 10mg/kg(+1,2d)。外周血干细胞动员 :环磷酰胺 2 0 0 0mg/m2 ,G -CSF 5ug/kg/d。结果 :造血干细胞采集量 :MNC 3.32× 10 9/Kg(2 .6 7- 4.2 8) ,患者造血功能重建迅速 ,免疫重建特征为CD4 ,CD19细胞减低 ,CD8,CD16+ 56细胞升高。随访 8例完全缓解 ,1例部分缓解 ,未发生移植相关的严重并发症。结论 :ABSCT治疗SLE近期临床疗效显著 ,远期疗效尚须进一步探讨。疗效机理可能与预处理后组织中免疫病理细胞的减少 ,免疫球蛋白降低 ,自身抗体量的下降有关。Objective To explore the clinical effect for treatment of SLE by autologous perpheral blood stem cells transplantation (ABSCT). Methods Nine SLE patients were chosen. Perpheral blood stem cells were collected by continuous-flow apheresis from patients using a Baxter CS-3000plus blood cell separator.Preparative regimen :TLI 12-16Gy, CTX 50mg/kg(-3,-2,-1day) and ATG 10 mg/kg(+1,2day) . Hemopoietic stem cells were mobilized into the peripheral blood by chemotherapeutic induction of transient myelosuppression . Perpheral blood stem cells were reinfused after conditioned by CTX 2000 mg/m2and G-CSF 5ug/kg/d. Results The count of colleted stenm cells: MNC 2.91×10 8/Kg(2.67-4.28). The character of immunologic reconstitution : CD 4?CD 19 cells decreased and CD 8?CD 16+56 cells increased.Eight patients received clinical complete remission after transplantation,only one patient was a part remission. There were earlier hematopoietic reconstitution and fewer complications . Conclusions ABSCT is effective obviously for SLE. Duration of remission remains to be decided in long-term follow up. Mechanisms of improvement are possibly related to decrease of immunologic pathological cells in tissues after conditioning, reduction of immunogloblins and drop of the quantity of auto-antibodies

关 键 词：系统性红斑狼疮 造血干细胞 移植 治疗 SLE 

分 类 号：R593.241[医药卫生—内科学]