CAJ | 학술논문

目的评价异基因造血干细胞移植(Allo-HSCT)治疗重型再生障碍性贫血(SAA)的疗效.方法 2003年3月至2009年5月接受Allo-HSCT治疗SAA患者4例,其中HLA位点全相合同胞供者3例,HLA 5个位点相合同胞供者1例.回顾性分析从诊断到移植时间、HSCT方式、预处理方案、植入时间、HSCT并发症和疗效等.结果诊断到移植时间平均70(19-180)d.HLA位点全相舍HSCT采用骨髓+外周血干细胞移植3例,HLA 5个位点相合HSCT采用骨髓+外周血+脐血干细胞移植1例,预处理方案均为环磷酰胺/抗人胸腺细胞球蛋白(CY/ATG).4例患者均植活,中性粒细胞绝对值(ANC)≥0.5×109/L和血小板(BPC)≥20 × 109/L中位时间分别为移植后14.5(9～28)d、16(9～28)d,其中2例患者发生Ⅰ度急性移植物抗宿主病(aGVHD),1例患者发生局限性慢性移植物抗宿主病(cGVHD).至随访截止日无死亡病例,中位生存40.6(2～63)个月.结论 Allo-HSCT是治愈SAA的有效方法,并且对于HLA位点不全相合同胞供者的Allo-HSCT,同样是安全有效的.
목적 평개이기인조혈간세포이식(Allo-HSCT)치료중형재생장애성빈혈(SAA)적료효.방법 2003년3월지2009년5월접수Allo-HSCT치료SAA환자4례,기중HLA위점전상합동포공자3례,HLA 5개위점상합동포공자1례.회고성분석종진단도이식시간、HSCT방식、예처리방안、식입시간、HSCT병발증화료효등.결과 진단도이식시간평균70(19-180)d.HLA위점전상사HSCT채용골수+외주혈간세포이식3례,HLA 5개위점상합HSCT채용골수+외주혈+제혈간세포이식1례,예처리방안균위배린선알/항인흉선세포구단백(CY/ATG).4례환자균식활,중성립세포절대치(ANC)≥0.5×109/L화혈소판(BPC)≥20 × 109/L중위시간분별위이식후14.5(9～28)d、16(9～28)d,기중2례환자발생Ⅰ도급성이식물항숙주병(aGVHD),1례환자발생국한성만성이식물항숙주병(cGVHD).지수방절지일무사망병례,중위생존40.6(2～63)개월.결론 Allo-HSCT시치유SAA적유효방법,병차대우HLA위점불전상합동포공자적Allo-HSCT,동양시안전유효적.
Objective To evaluate the therapeutic effects of allogeneic hematopoietic stem cell transplantat (allo-HSCT) for severe aplastic anemia (SAA). Methods Four patients of SAA underwent allo-HSCT at the bonemarrow transplant unit in our hospital from March 2003 to May 2009. Stem cell source was an HLA (human leukocyte antigen) matched related donor (MRD) in 3, HLA 1 (B) mismatched related donor in 1 patient A retrospective analysis was performed on interval from diagnosis to transplant,HSCT manners,conditioning regimens, hematopoiesis reconstitution, effectiveness and complication. Results The interval from diagnosis to transplant was 70 (19 - 180) days. Three patients (MRD) underwent BM + PBSCT, one was undergone BM + PBSC + CBSCT. Conditioning regimens of all patients were CY/ATG. Hematopoiesis reconstitution was achieved in 4 patients (100%). The median time of neutrophils which reached 0. 5 x 109/L and platelets reached 20 × 109/L were 14. 5 (9-28) and 16(9 -28) days. Two cases developed grade Ⅰ acute graft-versus-host diseaes (aGVHD), chronic local GVHD occurred in one patient. Four patients are alive with a median time of 40. 6(2 -63) months at the end of the following-up. Conclusions Allo-HSCT are an efficient and safe therapy for the patient with SAA,not only for patients with HLA matched related donor,but also for those only HLA mismatched related donor available.