达利珠单抗在未去T淋巴细胞单倍体相合的骨髓移植中的应用  

A study on non-T-cell depleted haploidentical bone marrow transplantation using Basiliximab for GVHD prophylaxis

作　　者：陈惠仁[1] 纪树荃[1] 王恒湘[1] 阎洪敏[1] 刘静[1] 朱玲[1] 薛梅[1] 贾晔辉[1] 

机构地区：[1]解放军空军总医院血液科,北京100036

出　　处：《中华器官移植杂志》2004年第3期165-167,共3页Chinese Journal of Organ Transplantation

摘　　要：目的　探讨达利珠单抗预防未去T淋巴细胞单倍体相合骨髓移植后移植物抗宿主病(GVHD)的效果。方法　 9例白血病患者接受单倍体相合的骨髓移植 ,HLA有 2～ 3个抗原错配 ,移植骨髓未去除T淋巴细胞 ,对受者除采取环孢素A、甲氨蝶呤、抗胸腺细胞球蛋白和霉酚酸酯联合应用等综合措施外 ,还分别在移植前 2h和移植后第 4d加用达利珠单抗预防GVHD。结果　 9例均获造血重建 ,骨髓植活直接证据证实为完全供者造血 ,无一例发生Ⅱ度以上急性GVHD ,除 1例因巨细胞病毒感染于移植后 3个月死亡外 ,其余患者存活均超过 1年 ,8例均发生局限性慢性GVHD ,现无病存活者 7例 ,1例在移植后 14个月因原发病复发死亡。结论　达利珠单抗联合其它免疫抑制措施对单倍体相合骨髓移植后的GVHD有较好的抑制作用。Objective To explore the effects of Basiliximab (Simulect) on reducing the incidence of severe acute GVHD in haploidentical bone marrow transplantation (BMT). Methods Nine patients with leukemia received haplotype Allo-BMT from HLA two or three loci mismatched related donor. Most patients were classified as high risk category. The donors of patients were administrated with G-CSF 250 μg/day for 7 doses prior to marrow harvest. In addition to combination of CsA, MTX, ATG and Mycophenolate mofetil for GVHD prophylaxis, Simulect was administered to prevent severe GVHD. A total 40 mg Simulect was given in two doses of 20 mg each by 30 min intravenous infusion on 2 h before transplantation and day 4 after transplantation.Results All patients were engrafted. 100 % donors hematopoietic cells after transplantation was determined by cytogenetic evidence analysis. None developed the Ⅱ-Ⅳ acute GVHD. Eight patients could be evaluated for chronic GVHD. All experienced chronic GVHD confined to the skin. The median follow-up duration was 14 months (range 12～20 months). One patient died from CMV infection on 3 months and one patient died from disease relapse on 14 months. The remaining 7 patients were survived in disease free situation.Conclusion The use of Simulect in haploidentical bone marrow transplantation is effective on preventing acute severe GVHD and improving disease-free survival.

关 键 词：达利珠单抗 去T淋巴细胞单倍体 骨髓移植 移植物抗宿主病 免疫抑制剂 

分 类 号：R457.7[医药卫生—治疗学]