CAJ | 학술논문

目的探讨造血生长因子对使用全身照射(TBI)进行干细胞移植预处理患者造血重建的影响,进而起到模拟事故性急性放射病,了解细胞因子在急性放射病患者救治中的作用.方法对1990-2012年75例预处理含TBI的造血干细胞移植患者及其供者的造血生长因子应用、植入情况、不良反应发生等进行回顾性分析,了解细胞因子在造血功能重建、造血干细胞动员中的作用以及不良反应.结果造血干细胞移植患者除1例因预处理不良反应死亡外,其他患者全部恢复造血功能重建.应用rhG-CSF组粒细胞植入的中位时间自体移植为10d、异基因移植为12d.自体移植患者应用rhIL-11组与未应用rhIL-11组血小板植入的时间分别为(11.67±1.53)、(13.70±6.27)d.所有TBI患者中口腔溃疡发生率为48％,腹泻发生率为44％.造血重建过程中细胞因子不良反应不明显,动员过程中半数出现轻度不良反应.结论细胞因子在TBI后造血功能重建以及移植时的造血干细胞动员中起关键作用.
목적 탐토조혈생장인자대사용전신조사(TBI)진행간세포이식예처리환자조혈중건적영향,진이기도모의사고성급성방사병,료해세포인자재급성방사병환자구치중적작용.방법 대1990-2012년75례예처리함TBI적조혈간세포이식환자급기공자적조혈생장인자응용、식입정황、불량반응발생등진행회고성분석,료해세포인자재조혈공능중건、조혈간세포동원중적작용이급불량반응.결과 조혈간세포이식환자제1례인예처리불량반응사망외,기타환자전부회복조혈공능중건.응용rhG-CSF조립세포식입적중위시간자체이식위10d、이기인이식위12d.자체이식환자응용rhIL-11조여미응용rhIL-11조혈소판식입적시간분별위(11.67±1.53)、(13.70±6.27)d.소유TBI환자중구강궤양발생솔위48％,복사발생솔위44％.조혈중건과정중세포인자불량반응불명현,동원과정중반수출현경도불량반응.결론 세포인자재TBI후조혈공능중건이급이식시적조혈간세포동원중기관건작용.
Objective To explore the influence of hematopoietic growth factors on the TBI patients in the conditioning regimen for stem cell transplantation,and to evaluate the effect of cytokines on treatment of acute radiation disease.Methods The usage of hematopoietic growth factors,implantations and the side-effects of the patients and donors of TBI in the conditioning regimen for stem cell transplantation were retrospectively analysed from 1990 to 2012,and the effect and side-effects of cytokines on the hematopoietic function recovery and stem cell mobilization were observed.Results All patients recovered from their hematopoietic function except one died due to the side-effecs.The median time of white blood cell recover was 10 d in auto-SCT and 12 d in allo-SCT in the G-CSF group.The median day of platelet recovery was 11.67 ± 1.53 in rhIL-11 arm and 13.70 ±6.27 in no rhIL-11 arm in the auto-SCT group.The incidence rates of dental ulcer and diarrhea in the TBI patients were 48％ and 44％,respectively.The occurrence of side-effect was rare in the period of cytokines treatment,but was over 50％ during stem cell mobilization.Conclusions Cytokines play very important roles in the hematopoietic function recovery and stem cell mobilization in the TBI patients.