CAJ | 학술논문

目的探讨非清髓性自体外周血造血干细胞移植(NAST)治疗难治性自身免疫病(AD)的远期疗效.方法总结5例接受NAST的AD患者移植后的随访情况.非清髓性预处理方案:移植前2d阿糖胞苷(200mg·kg-1·d-1)及环磷酰胺(40 mg· kg-1·d-1),均为静脉滴注.评价患者移植前后的相关症状体征的改变及远期并发症,流式细胞仪检测免疫功能的变化.结果 5例患者均成功植入.白细胞总数恢复正常的平均时间12d,血小板＞100×109/L的平均时间为10d,血红蛋白＞120 g/L的平均时间为22 d.随访中,NAST后5例患者临床症状和体症明显缓解,淋巴细胞亚群检测显示:CD4+及CD4+/CD8+均恢复正常.1例男性患者移植4年后妻子正常受孕并产下一健康女婴.4例女性均恢复正常工作与生活.结论与经典的清髓性HSCT治疗AD比较,NAST造血重建快,远期疗效确切.AD患者NAST治疗后生活质量好于清髓性HSCT.
목적 탐토비청수성자체외주혈조혈간세포이식(NAST)치료난치성자신면역병(AD)적원기료효.방법 총결5례접수NAST적AD환자이식후적수방정황.비청수성예처리방안:이식전2d아당포감(200mg·kg-1·d-1)급배린선알(40 mg· kg-1·d-1),균위정맥적주.평개환자이식전후적상관증상체정적개변급원기병발증,류식세포의검측면역공능적변화.결과 5례환자균성공식입.백세포총수회복정상적평균시간12d,혈소판＞100×109/L적평균시간위10d,혈홍단백＞120 g/L적평균시간위22 d.수방중,NAST후5례환자림상증상화체증명현완해,림파세포아군검측현시:CD4+급CD4+/CD8+균회복정상.1례남성환자이식4년후처자정상수잉병산하일건강녀영.4례녀성균회복정상공작여생활.결론 여경전적청수성HSCT치료AD비교,NAST조혈중건쾌,원기료효학절.AD환자NAST치료후생활질량호우청수성HSCT.
Objective To investigate the long-term efficacy of nonmyeloablative autologous peripheral blood stem cell transplantation (NAST) to cure refractory autoimmune disease (AD).Method Long-term follow up of four cases of AD patients with NAST were summarized.The pretreatment regimen was intravenous injection of cytarabin (200 mg· kg-1· d-1 ) and cyclophosphamide (40 mg· kg-1· d-1).The therapeutic effect was evaluated by the change of symptoms and signs and long term complications.Changes of immune function were detected by flow-cytometry.Results Five cases of patients had been successfully engrafted.The average time for peripheral leucocytes count to reach 4.0×109/L was 12 days.It needed 10 days for platelets to return to 100×109/L and 22 days for hemoglobin to 120 g/L.Apparent remission of symptoms and signs was observed after transplantation.Lymphocyte subtypes analysis pre- and post- NAST showed that count of CD4+ and the ratio of CD4 +/CD8 + was returned to normal.One patient gave birth to a healthy baby four years after transplantation.Three female patients returned to normal life. Conclusions Compared with classical myeloablative stem cell transplantation,NAST has a rapid hematopoietic recovery and good long-term therapeutic effect in AD.The quality of life in AD patients treated with NAST is higher than those treated with myeloablative hematopoietic stem cell transplantation.