免疫抑制联合脐带血输注治疗重型再生障碍性贫血的疗效  

Efficacy of immunosuppressive therapy combined with umbilical cord blood infusion in treatment of patients with severe aplastic anemia

作　　者：吴炜[1] 杨明珍[1] 夏瑞祥[1] 李庆生[1] 黄震琪[1] WU Wei;YANG Mingzhen;XIA Ruixiang(Department of Hematology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China)

机构地区：[1]安徽医科大学第一附属医院血液科,合肥230022

出　　处：《安徽医学》2017年第12期1523-1525,共3页Anhui Medical Journal

摘　　要：目的探讨免疫抑制联合脐带血输注治疗重型再生障碍性贫血(SAA)的临床疗效。方法选择2011年10月至2016年7月安徽医科大学第一附属医院收治的16例SAA患者,回顾分析患者的临床资料,并随访疗效。结果中位随访时间37(2~51)个月,总有效率为81.3%,2年无病生存率为81.3%,总生存率为87.5%。所有患者中性粒细胞>0.5×109/L的中位时间为治疗后14 d,13例有效患者脱离输血时间为治疗后25~180 d。监测短串联重复序列聚合酶链反应,1例患者治疗后56天脐血100%嵌合,第125天血常规恢复正常;1例患者治疗后第7天检测脐血100%嵌合,第25天转为受者100%嵌合,余14例患者脐带血均未植入。结论强化免疫抑制联合脐带血输注治疗成人SAA,并发症较少,疗效显著。ObjectiveTo investigate the effect of increased immunosuppressive treatment combined with unrelated umbilical cord blood infusion in patients with severe aplastic anemia.MethodA total of16patients with severe aplastic anemia who received the therapy of increased immunosuppressive(IST)regimen plus umbilical cord blood(UCB)infusion at our department were enrolled in the study.Results The median follow-up was37months.The total response rate was81.3%.The event-free survival of two years was81.3%and total survival rate was87.5%.The median time of neutrophil(count>0.5×109/L)was14d.Unexpected umbilical cord blood stem cell engraftment occurred in two patients,among whom one had100%chimerism of umbilical cord56days after treatment and returned to normal in routine blood test on125day,the other had100%chimerism of umbilical cord7days after treatment and returned to recipient100%chimerism.The others showed no signs of donor engraftment in chimerism analysis.ConclusionIntensive immunosuppressive therapy combined with umbilical cord blood infusion is effective for severe aplastic anemia.

关 键 词：再生障碍性贫血 重型 脐带血 免疫抑制 

分 类 号：R556.5[医药卫生—血液循环系统疾病]