非清髓造血干细胞移植治疗重型再生障碍性贫血  

Effect of nonmyeloablative allogeneic hematopoietic stem cell transplantation on severe aplastic anemia

作　　者：古健[1] 陈焯文[1] 

机构地区：[1]佛山市第一人民医院血液科,广东佛山528000

出　　处：《中国热带医学》2014年第12期1517-1519,共3页China Tropical Medicine

摘　　要：目的探讨非清髓造血干细胞移植治疗重型再生障碍性贫血（Severe alpastic anemia,SAA）的方法及疗效。方法对5例确诊的SAA患者进行了全相合的造血干细胞移植（Hematopoietic stem cell transplantation,HSCT）,预处理方案为：环磷酰胺（Cyclophosphamide,CY）＋氟达拉滨（Fludarabine,FLU）＋抗人胸腺球蛋白（Antithymocyte globulin,ATG）。观察采用该方案的非清髓预处理后患者造血重建时间及疗效。结果 5例患者移植后第10-14d供者造血重建,第30d行患者骨髓人类短串联重复序列复合扩增（Short tadom repeated-PCR,STR-PCR）检测显示为完全供者的基因型。其中1例出现I度急性移植物抗宿主病（Acute graft-versus-host disease,a GVHD）,2例口腔黏膜感染,1例肺部感染,随访至移植后3-28个月,造血功能恢复良好。结论以CY＋FLU＋ATG的非清髓性预处理方案造血干细胞移植治疗SAA,能够获得稳定的植入,且并发症少,是有效移植方法。Objective To investigate effect of the application of nonmyeloablative allogeneic hematopoietic stem cell transplantation in treatment of severe alpastic anemia（SAA）. Methods A total of 5 patients with SAA received HLA identical allogeneic hematopoietic stem cell transplantation, the conditioning regimens cyclophosphamide（CY）＋ fludarabine（FLU）＋ antithymocyte globulin（ATG） were used of the rebuild time and therapeutic effect was observed. Result Stem cells were grafted into 5 patients on ＋ 10-14d after transplantation. The DNA Finger printer showed evidence of complete donor implantation by short tandem repeat-polymerase chain reaction （STR-PCR） on ＋30d. First-degree acute graft-versus-host disease （aGVHD） was found in a patient, mouth mucosa infection in 2 patients, pneumonia in a patient. The patient were followed up for 3-28 months after HSCT, and the function of hemopoiesis was recovered well. Conclusions Nonmyeloablative allogeneic hematopoietic stem cell transplantation with the regimens of CY ＋ FLU ＋ ATG was effecive on severe alpastic anemia allows with good engraftment and without serious complications.

关 键 词：非清髓 造血干细胞移植 再生障碍性贫血 

分 类 号：R556[医药卫生—血液循环系统疾病]