中国医药
中國醫藥
중국의약
CHINA MEDICINE
2010年
10期
904-906
,共3页
王智明%王琳%陈晓霞%罗贤生%何丽莉%徐丹丹%李兴%符容香%王云英%黎丽琼%黄姿英%谭莲
王智明%王琳%陳曉霞%囉賢生%何麗莉%徐丹丹%李興%符容香%王雲英%黎麗瓊%黃姿英%譚蓮
왕지명%왕림%진효하%라현생%하려리%서단단%리흥%부용향%왕운영%려려경%황자영%담련
血液病%干细胞移植%移植物抗宿主反应
血液病%榦細胞移植%移植物抗宿主反應
혈액병%간세포이식%이식물항숙주반응
Hematologic diseases%Stem cell transplantation%Graft versus host reaction
目的 探讨异基因造血干细胞移植(Allo-HSCT)治疗恶性血液病时急性移植物抗宿主病(aGVHD)的预防策略.方法 对15例异基因造血干细胞移植患者联合采用重组人粒细胞集落刺激因子(rhG-CSF)动员,-7 d(回输干细胞前为-,回输后为+,回输时为0)始环孢素静脉滴注、麦考酚吗乙酯口服;-5～-4 d环磷酰胺静脉滴注,-5 d～-2 d抗胸腺细胞球蛋白静脉滴注;-6 d～+10 d白细胞介素11(IL-11)皮下注射;+1 d、+3 d、+6 d及+11 d甲氨蝶呤静脉滴注预防aGVHD.结果 15例患者完全植入,aGVHDⅡ～Ⅳ度的发生率20.0%,Ⅳ度的发生率6.7%,随访中位时间为30.7(4～65)个月,无复发,无恶性血液病存活.结论 异基因造血干细胞移植治疗恶性血液病时联合采用含有rhG-CSF、环孢素、麦考酚吗乙酯、环磷酰胺、抗胸腺细胞球蛋白、IL-11及短程甲氨蝶呤的方案预防aGVHD疗效可靠,值得推广.
目的 探討異基因造血榦細胞移植(Allo-HSCT)治療噁性血液病時急性移植物抗宿主病(aGVHD)的預防策略.方法 對15例異基因造血榦細胞移植患者聯閤採用重組人粒細胞集落刺激因子(rhG-CSF)動員,-7 d(迴輸榦細胞前為-,迴輸後為+,迴輸時為0)始環孢素靜脈滴註、麥攷酚嗎乙酯口服;-5～-4 d環燐酰胺靜脈滴註,-5 d～-2 d抗胸腺細胞毬蛋白靜脈滴註;-6 d～+10 d白細胞介素11(IL-11)皮下註射;+1 d、+3 d、+6 d及+11 d甲氨蝶呤靜脈滴註預防aGVHD.結果 15例患者完全植入,aGVHDⅡ～Ⅳ度的髮生率20.0%,Ⅳ度的髮生率6.7%,隨訪中位時間為30.7(4～65)箇月,無複髮,無噁性血液病存活.結論 異基因造血榦細胞移植治療噁性血液病時聯閤採用含有rhG-CSF、環孢素、麥攷酚嗎乙酯、環燐酰胺、抗胸腺細胞毬蛋白、IL-11及短程甲氨蝶呤的方案預防aGVHD療效可靠,值得推廣.
목적 탐토이기인조혈간세포이식(Allo-HSCT)치료악성혈액병시급성이식물항숙주병(aGVHD)적예방책략.방법 대15례이기인조혈간세포이식환자연합채용중조인립세포집락자격인자(rhG-CSF)동원,-7 d(회수간세포전위-,회수후위+,회수시위0)시배포소정맥적주、맥고분마을지구복;-5～-4 d배린선알정맥적주,-5 d～-2 d항흉선세포구단백정맥적주;-6 d～+10 d백세포개소11(IL-11)피하주사;+1 d、+3 d、+6 d급+11 d갑안접령정맥적주예방aGVHD.결과 15례환자완전식입,aGVHDⅡ～Ⅳ도적발생솔20.0%,Ⅳ도적발생솔6.7%,수방중위시간위30.7(4～65)개월,무복발,무악성혈액병존활.결론 이기인조혈간세포이식치료악성혈액병시연합채용함유rhG-CSF、배포소、맥고분마을지、배린선알、항흉선세포구단백、IL-11급단정갑안접령적방안예방aGVHD료효가고,치득추엄.
Objective To study the prophylaxis of acute graft versus host disease in hematopoietic malignancy patients with allogenic hematopoietic stem cell transplantation. Methods In 15 cases of allogenic hematopoietic stem cell transplantation, we adopted prophylaxis include recombinant human granulocyte colony stimulating factor(rhG-CSF) to mobilize donor stem cell, cyclosporine A (GSA) infusion and mycophenolate mofetil (MMF) oral from -7 d( "-" means befor infusion of donor stem cell, "+" means after infusion of donor stem cell), cyclophosphamide (CTX) infusion during - 5- - 4 d, anti-thymocyte globulin (ATG) infusion during - 5 d- - 2 d, interleukin 11(IL-11 ) subcutaneous injection during -2 d- + 10 d, methotrexate(MTX) infusion at +1 d, +3 d, +6 d and + 11 d to prevent aGVHD. Results All 15 cases achieved complete implantation. The incidence of aGVHD Ⅱ～Ⅳ degree was 20%. The incidence of aGVHD Ⅲ-Ⅳ degree was 6.7%. Median follow-up time was 30. 7(4-65)months. There was no relapse. All patients were hematopoietic malignancy free survival. Conclusion It is an effective prophylaxis and worth of spreading to prevent GVHD in hematopoietic malignancy patients with allogenic hematopoietic stem cell transplantation that combined uses rhG-CSF, GSA, MMF, CTX, ATG, IL-11, and shortterm MTX.
