CAJ | 학술논문

目的对比分析重型再生障碍性贫血(SAA)患者行亲缘全相合造血干细胞移植( HSCT)和强化免疫抑制治疗(IST)的效果.方法 2008年1月至2010年12月新入院并诊断为SAA者41例,其中14例行亲缘全相合HSCT,27例接受以抗胸腺细胞球蛋白(ATG)+环孢素A(CsA)为基础的IST.结果行亲缘全相合HSCT的14例全部植活,治疗有效率100％,中位随访14个月,患者均无病存活;接受IST的27例中位随访16个月,其中21例治疗有效(77.8％),6例治疗无效,2例死亡,患者脱离输血的中位时间为132 d.接受IST者的治疗有效率、存活率和死亡率与接受亲缘全相合HSCT者相比较,差异有统计学意义(P＜0.01).结论亲缘全相合HSCT治疗SAA的效果令人满意,优于IST.
목적 대비분석중형재생장애성빈혈(SAA)환자행친연전상합조혈간세포이식( HSCT)화강화면역억제치료(IST)적효과.방법 2008년1월지2010년12월신입원병진단위SAA자41례,기중14례행친연전상합HSCT,27례접수이항흉선세포구단백(ATG)+배포소A(CsA)위기출적IST.결과 행친연전상합HSCT적14례전부식활,치료유효솔100％,중위수방14개월,환자균무병존활;접수IST적27례중위수방16개월,기중21례치료유효(77.8％),6례치료무효,2례사망,환자탈리수혈적중위시간위132 d.접수IST자적치료유효솔、존활솔화사망솔여접수친연전상합HSCT자상비교,차이유통계학의의(P＜0.01).결론 친연전상합HSCT치료SAA적효과령인만의,우우IST.
Objective To retrospectively analyze and compare the curative outcome of hematopoietic stem cell transplantation (HSCT) from HLA identical siblings vs intensive immunosuppression therapy (IST) for severe aplastic anemia (SAA).Methods From January 2008 to December 2010,41 patients with severe aplastic anemia were treated with related HSCT (n =14) or IST (n =27) which combined antithymocyte globulin (ATG) with cyclosporine-A (CsA) therapy.Results All the patients receiving HSCT reached complete response.Among the patients receiving IST,21 patients could be responsive to the therapy,and 2 patients died.There was significant difference in the response rate between HSCT group and IST group (100 ％ vs 77.8 ％,P＜0.01 ).Conclusion With the improvement of HSCT technology,the curative outcome of HSCT from HLA identical siblings for SAA is much better than IST.