| 摘要: |
| ［摘要］ 目的 评价以环磷酰胺（CTX）为预处理方案行异基因造血干细胞移植（Allo-HSCT）治疗重症再生障碍性贫血（SAA）的疗效。方法 对1例SAA患者行同胞供者Allo-HSCT治疗。预处理方案为CTX 50 mg/kg-1·d-1×4 d；干细胞来源采用外周血+骨髓；输注单个核细胞数（MNC）为10.41×108/kg，CD34+细胞计数为6.86×106/kg。预防移植物抗宿主病(GVHD)采用环孢素A（CsA）加短程甲氨蝶呤（MTX）加霉酚酸酯（MMF）。结果 患者获得造血重建，第14天中性粒细胞数（ANC）≥0.5×109/L、血小板计数（PLT）≥20×109/L，第96天血型转变为供者型（B→O）。患者出现Ⅳ度急性GVHD（aGVHD），经积极治疗后控制。150 d内患者出现急性化脓性扁桃体炎、口腔溃疡、急性支气管炎、带状疱疹病毒感染、巨细胞病毒血症、肺炎,经积极治疗后均好转。随访24个月，患者无病存活。结论 以CTX为预处理方案allo-HSCT是治愈SAA的一种有效方法。 |
| 关键词: 重症再生障碍性贫血 异基因 造血干细胞移植 预处理 |
| DOI：10.3969/j.issn.1674-3806.2011.08.09 |
| 分类号:R 556.5 |
| 基金项目: |
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| Allogeneic hemapoietic stem cell transplantation for severe aplastic anaemia |
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LAN Mei，GAO Qing-ping
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Department of Hematology，the People′s Hospital of Wuhan Univiersity, Wuhan 430060, China
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| Abstract: |
| ［Abstract］ Objective To evaluate the clinical effect of allogeneic hemapoietic stem cell transplantation(Allo-HSCT) with cyclophosphamide (Cy) as conditioning regimen for severe aplastic anaemia(SAA). Methods One patient with SAA received HLA matched allo-HSCT. Conditioning regimen was Cy 50 mg/kg-1 · d-1×4 d. The peripheral blood stem cells (PBSC) + bone marrow stem cells (BMSC) were used as the source of grafts. The infused number of mononuclear cells were 10.41×108/kg and the number of CD34(+) cells were 6.86×106/kg. Cyclosporine A (CsA) and short-course methotrexate(MTX ) and mycophenlate mofetil(MMF) were administered to prevent the graft versus host disease(GVHD). Results The patient was engrafted. The time for granulocyte count 0.5×109/L and platelet count 20×109/L were 14 days. The blood type was changed into the type donor(B→O) in +96 days. Grade Ⅳ aGVHD developed and was controlled in the patient. Acute suppurative tonsillitis, dental ulcer, acute bronchitis, herpes zoster virus infection, cytomegalovirus viremia and peeumonia occurred in 150 days after allo-HSCT, and these complications were properly disposed. With follow-up of 24 months, the patient survived with disease free. Conclusion Allo-HSCT with cyclophosphamide as conditioning regimens is a method for curing the patient with SAA. |
| Key words: Severe aplastic anaemia Allogene Stem cell transplantation Conditioning regimen |
