CAJ | 학술논문

目的观察异基因造血干细胞移植(allo-HSCT)治疗儿童恶性血液病的疗效和相关并发症,探讨allo-HSCT治疗儿童恶性血液病的适应证.方法回顾性分析15例接受allo-HSCT治疗的儿童恶性血液病患者的临床资料,其中13例为急性白血病,1例为慢性粒细胞白血病(加速期),1例为骨髓增生异常综合征(MDS-REBT);8例为亲缘供者,7例为非亲缘供者;11例行外周血造血干细胞移植治疗,4例行脐血造血干细胞移植治疗;6例为HLA配型全相合,9例为HLA配型不全相合.结果 15例患儿中生存7例,生存期为5个月～6年;5例因复发或重症感染放弃治疗;3例死亡.6例发生急性移植物抗宿主病(GVHD),包括Ⅰ度3例,Ⅱ、Ⅲ、Ⅳ度各1例,其中发生Ⅳ度急性GVHD患儿死亡.2例发生广泛性慢性GVHD,其中1例死亡,另1例生活质量严重受影响.结论 allo-HSCT是治疗儿童恶性血液病的重要方法,其并发症多、风险大,在防治并发症的同时,应严格把握allo-HSCT治疗儿童恶性血液病的适应证.
목적 관찰이기인조혈간세포이식(allo-HSCT)치료인동악성혈액병적료효화상관병발증,탐토allo-HSCT치료인동악성혈액병적괄응증.방법 회고성분석15례접수allo-HSCT치료적인동악성혈액병환자적림상자료,기중13례위급성백혈병,1례위만성립세포백혈병(가속기),1례위골수증생이상종합정(MDS-REBT);8례위친연공자,7례위비친연공자;11례행외주혈조혈간세포이식치료,4례행제혈조혈간세포이식치료;6례위HLA배형전상합,9례위HLA배형불전상합.결과 15례환인중생존7례,생존기위5개월～6년;5례인복발혹중증감염방기치료;3례사망.6례발생급성이식물항숙주병(GVHD),포괄Ⅰ도3례,Ⅱ、Ⅲ、Ⅳ도각1례,기중발생Ⅳ도급성GVHD환인사망.2례발생엄범성만성GVHD,기중1례사망,령1례생활질량엄중수영향.결론 allo-HSCT시치료인동악성혈액병적중요방법,기병발증다、풍험대,재방치병발증적동시,응엄격파악allo-HSCT치료인동악성혈액병적괄응증.
Objective To observe the therapeutic efficiency and associated complications of allogeneic hematopoietic stem cells transplantation (allo-HSCT) for treatment of children with malignant hematological disease.Methods Fifteen children with malignant hematological disease were subjected to allo-HSCT from Jan 2007 to Jan 2013.Among those 15 patients,13 cases were diagnosed as acute leukemia (AL),1 case as chronic myeloid leukemia (CML),and 1 case as myelodysplastic syndrome (MDS-RAEB).The clinical characters of all cases after transplantation were analyzed retrospectively.Results Seven cases survived from 5 months to 6 years after transplantation.Five cases abandoned treatment because of relapse or severe infections.Three cases developed grade Ⅰ acute graft-versus-host disease (aGVHD),three cases developed grade Ⅱ,Ⅲ and Ⅳ aGVHD respectively,and one case died of Ⅳ aGVHD.Two patients experienced extensive chronic graft-versus-host disease (cGVHD),in whom one died of cGVHD,the other suffered with poor quality of life.Conclusions Allo-HSCT is an efficient operation for the treatment of children with hematologic malignancies.Reduction of complications associated with allo-HSCT is the first issue needs to be overcome,meanwhile,it is also important to understand the indications of children allo-HSCT.