中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2010年
8期
531-535
,共5页
罗成娟%陈静%薛惠良%汤静燕%潘慈%江华%董璐%罗长缨%叶启东%周敏%顾龙君
囉成娟%陳靜%薛惠良%湯靜燕%潘慈%江華%董璐%囉長纓%葉啟東%週敏%顧龍君
라성연%진정%설혜량%탕정연%반자%강화%동로%라장영%협계동%주민%고룡군
贫血,再生障碍性%儿童%造血干细胞移植%免疫抑制治疗
貧血,再生障礙性%兒童%造血榦細胞移植%免疫抑製治療
빈혈,재생장애성%인동%조혈간세포이식%면역억제치료
Anemia,aplastic%Children%Hematopoietic stem cell transplantation%Immunosuppressive therapy
目的 分析免疫抑制疗法(IST)和异基因造血干细胞移植(allo-HSCT)治疗儿童再生障碍性贫血(AA)的疗效.方法 对125例在上海儿童医学中心接受治疗的AA患儿的临床资料进行回顾性分析.结果 125例AA患儿分为重型AA(SAA)(79例)、非重型AA(NSAA)(46例)两组,中位随访25(6～89)个月,两组在发病年龄、性别和随访时间上差异无统计学意义(P值均＞0.05).103例患儿接受IST,22例接受HSCT.SAA组中,接受HSCT者(21例)疗效明显优于接受IST者(58例)(有效率分别为85.7%和53.4%,P＜0.01);IST中,接受抗胸腺细胞免疫球蛋白(ATG)+环孢素(CsA)联合治疗者(47例)与单纯接受CsA治疗者(11例)比较,治愈率(分别为42.6%和27.3%,P=0.499)与有效率(55.3%和45.5%,P=0.555)差异均无统计学意义.NSAA组中,45例接受IST,1例接受HSCT,接受ATG+CsA联合治疗者(11例)其治愈率(36.4%)和有效率(63.6%)与单纯接受CsA治疗者(34例)(分别为32.4%和64.7%)比较,差异无统计学意义(P值均＞0.05).结论 我国儿童AA中,allo-HSCT疗效明显优于IST;对无合适供者的SAA患者,IST仍然是一种有效的治疗方法.
目的 分析免疫抑製療法(IST)和異基因造血榦細胞移植(allo-HSCT)治療兒童再生障礙性貧血(AA)的療效.方法 對125例在上海兒童醫學中心接受治療的AA患兒的臨床資料進行迴顧性分析.結果 125例AA患兒分為重型AA(SAA)(79例)、非重型AA(NSAA)(46例)兩組,中位隨訪25(6～89)箇月,兩組在髮病年齡、性彆和隨訪時間上差異無統計學意義(P值均＞0.05).103例患兒接受IST,22例接受HSCT.SAA組中,接受HSCT者(21例)療效明顯優于接受IST者(58例)(有效率分彆為85.7%和53.4%,P＜0.01);IST中,接受抗胸腺細胞免疫毬蛋白(ATG)+環孢素(CsA)聯閤治療者(47例)與單純接受CsA治療者(11例)比較,治愈率(分彆為42.6%和27.3%,P=0.499)與有效率(55.3%和45.5%,P=0.555)差異均無統計學意義.NSAA組中,45例接受IST,1例接受HSCT,接受ATG+CsA聯閤治療者(11例)其治愈率(36.4%)和有效率(63.6%)與單純接受CsA治療者(34例)(分彆為32.4%和64.7%)比較,差異無統計學意義(P值均＞0.05).結論 我國兒童AA中,allo-HSCT療效明顯優于IST;對無閤適供者的SAA患者,IST仍然是一種有效的治療方法.
목적 분석면역억제요법(IST)화이기인조혈간세포이식(allo-HSCT)치료인동재생장애성빈혈(AA)적료효.방법 대125례재상해인동의학중심접수치료적AA환인적림상자료진행회고성분석.결과 125례AA환인분위중형AA(SAA)(79례)、비중형AA(NSAA)(46례)량조,중위수방25(6～89)개월,량조재발병년령、성별화수방시간상차이무통계학의의(P치균＞0.05).103례환인접수IST,22례접수HSCT.SAA조중,접수HSCT자(21례)료효명현우우접수IST자(58례)(유효솔분별위85.7%화53.4%,P＜0.01);IST중,접수항흉선세포면역구단백(ATG)+배포소(CsA)연합치료자(47례)여단순접수CsA치료자(11례)비교,치유솔(분별위42.6%화27.3%,P=0.499)여유효솔(55.3%화45.5%,P=0.555)차이균무통계학의의.NSAA조중,45례접수IST,1례접수HSCT,접수ATG+CsA연합치료자(11례)기치유솔(36.4%)화유효솔(63.6%)여단순접수CsA치료자(34례)(분별위32.4%화64.7%)비교,차이무통계학의의(P치균＞0.05).결론 아국인동AA중,allo-HSCT료효명현우우IST;대무합괄공자적SAA환자,IST잉연시일충유효적치료방법.
Objective To analyze the outcome of childhood aplastic anemia received allogenic hematopoietic stem cell transplantation(HSCT) and immunosuppressive therapy(IST). Methods The clinical data of 125 consecutive children with aplastic anemia(AA) in our hospital were retrospectively analyzed. Resuits According to the clinical manifestations, the 125 AA children were divided into two groups : SAA ( n=79) and NSAA ( n= 46). There was no significant difference between the two groups in sex, age and followup duration (P>0.05 ). The median follow-up was 25 (6-89) months. 103 cases received IST and 22 received allogenic HSCT. In SAA group, the response rate was better in patients received allogenic HSCT(n=21 ) than in those received IST (n=58 ) (85.7% vs 53.4%, P < 0.01 ). SAA patients received IST were further divided into two groups :47 received antithymocyte globulin (ATG) and cyclosporine-A (CsA) combined therapy, 11 received CsA alone. There was no significant difference in total response rates (55.3% vs 45.5% ,P=0.555 ) and cure rates (42.6% vs 27.3% ,P=0.499) between the two groups. In NSAA group,45 patients received IST and 1 received allogenic HSCT. In the IST treated NSAA patients, there was also no statistic significance in cure rates ( 36.4% vs 32.4%, P=0.806) and total effective rates(63.6% vs 64.7 %,P=0.949) between ATG and CsA combined therapy ( n=11 ) and CsA alone therapy (n=34 ). Conclusion The outcome of children with AA received allogenic HSCT was obviously better than those received IST.IST is still the choice for patients without suitable donors for HSCT.
