重型再生障碍性贫血患者行非清髓性异基因外周血造血干细胞移植治疗的疗效分析  

Therapeutic Effect of Non-myeloablative Allogeneic Peripheral Blood Stem Cell Transplantation in Patients with Severe Aplastic Anemia

作　　者：陈根定 CHEN Gending(Department of Hematoendocrinology,922nd Hospital of PLA Joint Logistics Support Force,Hengyang City,Hu’nan Province 421002)

机构地区：[1]解放军联勤保障部队第九二二医院血液内分泌科

出　　处：《医学理论与实践》2019年第21期3407-3409,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探究重型再生障碍性贫血患者行非清髓性异基因外周血造血干细胞移植治疗效果及其并发症。方法:为9例年轻的重型再生障碍性贫血患者进行了同胞HLA结合外周血造血干细胞移植。观察移植后造血功能恢复情况及临床并发症情况,移植后观察近期情况,采用40d、180d以及360d短片段重复序列进行动态监测。结果:所有患者需接受供者外围MNC细胞数以及CD34+细胞,ANC平均增加到0.5×10^9/L用时为14.5d,PLT平均增加到20×10^9/L用时为23.5d。所有患者中有2例发生Ⅱ度急性移植物抗宿主病,1例发生Ⅰ度急性移植物抗宿主病,3例局限性慢性移植物抗宿主病,CMV血症出现5例,更昔洛韦治疗出现效果,1例曲霉菌性肺炎和2例念珠菌肠炎,抗真菌治疗后治愈,2例出血性膀胱炎,2例口腔溃疡。结论:非清髓性异基因外周血造血干细胞造血功能恢复快,移植效率高,并发症少,为了在其他重型再生障碍性贫血患者中取得良好的效果,进一步的临床验证是必要的。Objective:To investigate the efficacy and complications of peripheral blood hematopoietic stem cell transplantation of non-myeloablative allogeneic cells in patients with severe aplastic anemia.Methods:9 patients with SAA underwent HLA combined with peripheral blood hematopoietic stem cell transplantation.The recovery of hematopoietic function and clinical complications after transplantation were observed,and the recent situation was observed after transplantation.Short fragment repeat sequences of 40d,180d and 360d were used for dynamic monitoring.Results:The number of peripheral MNC cells and CD34+cells must be accepted by all patients.The average increase of ANC to 0.5×10^9/L took 14.5d,and the average increase of PLT to 20×10^9/L took 23.5d.All cases have happened in 2 cases Ⅱ degree of acute graft versus host disease,1 case happenedⅠdegree of acute graft versus host disease,3 cases of limitations of chronic graft versus host disease,CMV disease appear in 5 cases,appear more yesterday galloway treatment effect,1 case of aspergillus pneumonia and 2 cases of candida enteritis,after antifungal treatment cured,2 cases of hemorrhagic cystitis,2 cases of oral ulcer.Conclusion:Non-myeloablative peripheral blood hematopoietic stem cells have rapid recovery of hematopoietic function,high transplantation efficiency and few complications.In order to achieve good results in other SAA patients,further clinical verification is necessary.

关 键 词：非清髓性异基因外周血造血干细胞 重型再生障碍性贫血 疗效 

分 类 号：R556.5[医药卫生—血液循环系统疾病]