小剂量地西他滨在异基因造血干细胞移植后早期复发及cGVHD治疗中的作用  

Role of small-dose decitabine in treatment of early recurrence and chronic graft versus host disease after allogeneic hematopoietic stem cell transplantation

作　　者：王晓果[1] 陈婷[1] 刘焕凤[1] 邓天霞 刘俊[1] 张诚[1] 张曦[1] 孔佩艳[1] 

机构地区：[1]第三军医大学新桥医院全军血液病中心,重庆400037

出　　处：《第三军医大学学报》2016年第12期1362-1365,共4页Journal of Third Military Medical University

摘　　要：目的分析小剂量地西他滨(decitabine/dacogen,DAC)治疗异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,allo-HSCT)后慢性移植物抗宿主病(chronic graft versus host disease,c GVHD)患者的转归情况。方法收集2013年6月25日至2015年7月7日我院行alloHSCT术后早期复发及发生c GVHD,并接受小剂量DAC治疗的4例患者,包括急性髓系白血病(acute myeloid leukemia,AML)3例,骨髓增生异常综合征(myelodysplastic syndrome,MDS)1例。对其诊断、移植方式、c GVHD分型及评分、以及DAC治疗后转归进行分析。结果 4例接受小剂量DAC的患者,c GVHD症状减轻,无严重的血液学毒性。1例因严重肺部感染放弃治疗,3例目前病情稳定。结论小剂量DAC可减轻allo-HSCT术后c GVHD症状,改善患者生存质量,并对早期复发的控制有一定的效果。Objective To analyze the outcomes of 4 cases of chronic graft versus host disease（ c GVHD） after allogeneic hematopoietic stem cell transplantation（ allo-HSCT） treated by small-dose decitabine / dacogen（ DAC）. Methods Clinical data of 4 patients who have c GVHD effects and early recurrence after allo-HSCT,and then received small-dose DAC treatment in our hospital from June 25,2013 to July 7,2015 were collected in this study. Three of them were acute myeloid leukemia（ AML）,and the other1 case was myelodysplastic syndrome（ MDS）. Their diagnosis,transplantation methods,types and scores of c GVHD,and treatment outcome were retrospectively analyzed. Results All 4 patients had decreased effects of c GVHD and had no severe hematologic toxicity after small-dose DCA therapy. One of the patients gave up the treatment because of pulmonary infection,and the other 3 ones were in stable disease stage till now.Conclusion Small-dose DAC therapy alleviates c GVHD after allo-HSCT,improves quality of life in the patients,and has certain effect on controlling early recurrence.

关 键 词：地西他滨 异基因造血干细胞移植 移植物抗宿主病 

分 类 号：R617[医药卫生—外科学] R730.53[医药卫生—临床医学]