CAJ | 학술논문

目的探索氟迭拉滨(Flu)+环磷酰胺(CTX)预处理方案(FC预处理方案)异基因造血干细胞移植治疗重型再障的可行性.方法 9例重型再障患者接受HLA全相舍异基因造血干细胞移植.预处理方案采用FC方案:即氟迭拉滨(Flu)30 mg/m2.静脉滴注,1/d,d-6-d-2,共5 d;环磷酰胺(CTX)50 mg/kg,静脉滴注,1/d,d-5-d-2,共4 d.环孢素A(CsA)+骁悉(MMF)联合方案预防移植物抗宿主病(GVHD).结果 9例患者均成功植入,中性粒细胞≥0.5×109/L的时间中位时间为12(10-16)d,PLT≥20×109/L的时间中位时间为14(12-19)d.移植后30 d检测证实均为供者型完全嵌合状态.1例发生肠道Ⅱ度急性GVHD,1例发生皮肤I度急性GVHD,1例出现慢性GVHD,II度以上(含Ⅱ度)急性GVHD总发生率仅为11.1%.中位随访时间39个月.9例患者均无病存活.结论 FC预处理方案植入率高.预处理相关并发症少,无病生存率高,临床疗效好.
목적 탐색불질랍빈(Flu)+배린선알(CTX)예처리방안(FC예처리방안)이기인조혈간세포이식치료중형재장적가행성.방법 9례중형재장환자접수HLA전상사이기인조혈간세포이식.예처리방안채용FC방안:즉불질랍빈(Flu)30 mg/m2.정맥적주,1/d,d-6-d-2,공5 d;배린선알(CTX)50 mg/kg,정맥적주,1/d,d-5-d-2,공4 d.배포소A(CsA)+효실(MMF)연합방안예방이식물항숙주병(GVHD).결과 9례환자균성공식입,중성립세포≥0.5×109/L적시간중위시간위12(10-16)d,PLT≥20×109/L적시간중위시간위14(12-19)d.이식후30 d검측증실균위공자형완전감합상태.1례발생장도Ⅱ도급성GVHD,1례발생피부I도급성GVHD,1례출현만성GVHD,II도이상(함Ⅱ도)급성GVHD총발생솔부위11.1%.중위수방시간39개월.9례환자균무병존활.결론 FC예처리방안식입솔고.예처리상관병발증소,무병생존솔고,림상료효호.
Objective To evaluate the efficacy of Flu/CTX conditioning regimen for the treatment of severe aplastic anemia in pa- tients receiving allogeneic hematopoietic stem cell transplantation. Methods Nine patients with severe aplastic anemia received HLA identi- cal peripheral blood hematopoietic stem cell transplantation (PBSCT) using Flu/CTX conditioning regimen, which consisted of fludarbine [30 mg/(m2 d) for5 days (-7 to -3) ], CTX [50mg/(kg d) for4 days(-5 to-2)]. All patients received cyclosporin A (CsA) and mycophenolet mofetil (MMF) for prophylaxis of graft-versus-host disease(GVHD). Results The Fiu/CTX regimen was very well toler- ated, with no severe regimen related toxicity. In all patients, the median days of neutrephil exceeding 0. 5×109/L and platelet exceeding 20 ×109/L were 12 days (range 10-16 days) and 16 days (range 14-19 days), respectively. Complete chimerism was achieved in all pa- tients at one month after PBSCT. Two patients had acute GVHD and one had chronic GVHD. In the 39-month median follow-up duration, all patients were alive in disease-free situation. Conclusion The Flu/CTX conditioning regimen may reduce transplantation-related toxicities and can achieve full chimerism and high long-term disease-free survival. Allogeneic hematopoietic stem cell transplantation using intravenous Fiu/CTX conditioning regimen is a safe and effective treatment method for the patients with severe aplastic anemia.