CAJ | 학술논문

目的探讨干细胞移植(HSCT)在骨髓增生异常综合征(MDS)治疗中的疗效以及预处理方式的选择.方法对13例MDS患者行异基因造血干细胞移植(allo-HSCT)(包括HLA配型全相合10例、半相合2例、脐血移植1例).输注单个核细胞(MNC)6.92(2.65～21.33)×108/kg,CD34细胞4.47(1.49～10.22)×106/kg.其中,5例选择全身照射+氟达拉滨+环磷酰胺(TBI+Flud+Cy)方案预处理,3例白消安(BU)/Cy预处理,3例TBI+CY,2例采用阿糖胞苷(Ara-C)+BU+Cy+替尼泊苷(VM26)预处理.移植物抗宿主病(GVHD)的预防:2例HLA配型半相合者给予抗胸腺细胞球蛋白(ATG)联合环孢素A(CsA)加短程甲氨蝶呤(MTX)治疗,并于移植后1～28 d持续给予霉酚酸酯(MMF),其他病例仅给予CsA加短程MTX.结果 13例患者中9例造血完全重建,移植相关死亡4例.结论 HSCT是可以治愈MDS的有效方法.预处理选择应采取个体化.
목적 탐토간세포이식(HSCT)재골수증생이상종합정(MDS)치료중적료효이급예처리방식적선택.방법 대13례MDS환자행이기인조혈간세포이식(allo-HSCT)(포괄HLA배형전상합10례、반상합2례、제혈이식1례).수주단개핵세포(MNC)6.92(2.65～21.33)×108/kg,CD34세포4.47(1.49～10.22)×106/kg.기중,5례선택전신조사+불체랍빈+배린선알(TBI+Flud+Cy)방안예처리,3례백소안(BU)/Cy예처리,3례TBI+CY,2례채용아당포감(Ara-C)+BU+Cy+체니박감(VM26)예처리.이식물항숙주병(GVHD)적예방:2례HLA배형반상합자급여항흉선세포구단백(ATG)연합배포소A(CsA)가단정갑안접령(MTX)치료,병우이식후1～28 d지속급여매분산지(MMF),기타병례부급여CsA가단정MTX.결과 13례환자중9례조혈완전중건,이식상관사망4례.결론 HSCT시가이치유MDS적유효방법.예처리선택응채취개체화.
Objective To investigate the curative effect of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the method of the pretreatment choice on myelodysplastic syndrome (MDS).Methods 13 cases who were undergoing allo-HSCT including 10 HLA-matched, 2 HLA partially matched,and one umbilical cord blood transplanted patients were enrolled in this study. The infusion number of MNC and CD+34 cells is 6.92 (2.65-21.33)×108/kg and 4.47 (1.49-10.22) ×106/kg, respectively. Of the 13 cases,5 adopted TBI, fludarabine(Flud), and cyclophosphamide(Cy) pretreatment, 3 chose BU/Cy pretreatment, and 3 chose TBI and Cy pretreatment, 2 chose Ara-C+BU+Cy+VM26 pretreatment. In order to prevent GVHD, 2cases of HLA partially matched were treated with ATG, cyclosporin A (CsA), MTX and MMF aftertransplantation, while the others were treated with CsA and MTX only. Results 9 out of 13 cases achieved hematopoietic reconstruction completely. 4 died of complications. Conclusion The allogeneic hematopoietic stem cell transplantation is an efficient regimen to cure MDS. The pretreatment should adopt the individuation.