CAJ | 학술논문

目的观察英夫利西单抗治疗异基因造血干细胞移植后发生肠道急性移植物抗宿主病(GVHD)的有效性和安全性.方法北京军区总医院血液科于2012年1月至2015年1月应用英夫利西单抗治疗15例移植后发生肠道急性GVHD的患者,均为Ⅲ～Ⅳ度肠道GVHD,其中男9例,女6例,平均年龄28.8岁,5例为HLA配型全相合,10例为HLA配型不全相合,肠道GVHD发生的中位时间是移植后66.7d.英夫利西单抗治疗方法为每次5 mg/kg,1次/周,根据肠道GVHD控制情况应用1～4次.观察患者的有效性和输注相关毒副作用.结果输注英夫利西单抗后患者总体不良反应较轻,7例肠道GVHD得到完全缓解,3例部分缓解,无效5例,总有效率为66.7％.随访至2015年1月,中位随访时间11.1个月.全部患者中5例死于肠道GVHD,3例患者死于复发,1例死于感染,其他患者仍处于完全缓解状态,无病生存率为40％,最长无病生存时间已达32个月.结论英夫利西单抗治疗移植后肠道急性GVHD疗效显著,副作用小.
목적 관찰영부리서단항치료이기인조혈간세포이식후발생장도급성이식물항숙주병(GVHD)적유효성화안전성.방법 북경군구총의원혈액과우2012년1월지2015년1월응용영부리서단항치료15례이식후발생장도급성GVHD적환자,균위Ⅲ～Ⅳ도장도GVHD,기중남9례,녀6례,평균년령28.8세,5례위HLA배형전상합,10례위HLA배형불전상합,장도GVHD발생적중위시간시이식후66.7d.영부리서단항치료방법위매차5 mg/kg,1차/주,근거장도GVHD공제정황응용1～4차.관찰환자적유효성화수주상관독부작용.결과 수주영부리서단항후환자총체불량반응교경,7례장도GVHD득도완전완해,3례부분완해,무효5례,총유효솔위66.7％.수방지2015년1월,중위수방시간11.1개월.전부환자중5례사우장도GVHD,3례환자사우복발,1례사우감염,기타환자잉처우완전완해상태,무병생존솔위40％,최장무병생존시간이체32개월.결론 영부리서단항치료이식후장도급성GVHD료효현저,부작용소.
Objective To observe the effectiveness and safety of infliximab on acute intestinal graftversus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation.Methods Fifteen patients were diagnosed with grade Ⅲ to Ⅳ acute intestinal GVHD after transplantation in the Department of Hematology,Military General Hospital of Beijing PLA from January 2012 to January 2015,9 males and 6 females,average age was 28.8 years (8～ 45 years).Among them,5 cases with HLA matching identical,and 10 cases with HLA mismatched.The median time of intestinal GVHD was 66.7 (35 ～ 90) days after transplantation.The method of infliximab treatment was 5 mg/kg,once per week,then applicated 1 to 4 times according to the situation of intestinal GVHD control.Effectiveness and the related toxicity were observed.Results The overall adverse reactions were relatively light with infliximab.Seven cases obtained complete remission,3 cases with partial remission,other 5 cases were ineffective,and the total efficiency of 66.7％.Follow up to January 2015,the median follow-up was 11.1 months (2 to 32 months).Five cases died of intestinal GVHD,3 patients died of recurrence,1 cases died of infection,other patients are still in complete remission,and the disease free survival rate was 40％,of which the longest disease-free survival was 32 months.Conclusion Infliximab shows significant efficacy and small adverse side effects for acute intestinal GVHD.