活体亲属肝移植后再生障碍性贫血的成功造血干细胞移植。

Successful hematopoietic stem cell transplantation for aplastic anemia following living-related liver transplantation.

作者信息

Umeda K, Adachi S, Watanabe K, Kimura N, Lin Y, Nakahata T

机构信息

Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

Bone Marrow Transplant. 2002 Oct;30(8):531-4. doi: 10.1038/sj.bmt.1703689.

DOI:10.1038/sj.bmt.1703689

PMID:12379894

Abstract

A 1-year-old boy received a living-related liver transplantation (LRLT) from his HLA-haploidentical father to treat acute liver failure following non-A, non-B, non-C hepatitis. He subsequently developed pancytopenia and was diagnosed with aplastic anemia (AA). He was platelet transfusion dependent and developed two episodes of life-threatening intracranial hemorrhage despite immuno-suppressive therapy consisting of cyclosporin A, antithymocyte globulin, and anabolic steroids. He received combined hematopoietic stem cell transplantation (hSCT) with cord blood and bone marrow from an HLA-matched sibling. Conditioning consisted of cyclophosphamide (CY) 200 mg/kg and 7 Gy total lymphoid irradiation (TLI). Marrow engraftment was prompt and there was no significant graft-versus-host disease (GVHD).

摘要

一名1岁男孩接受了与其HLA单倍型相同的父亲提供的活体亲属肝移植（LRLT），以治疗非甲、非乙、非丙型肝炎后的急性肝衰竭。随后他出现全血细胞减少，并被诊断为再生障碍性贫血（AA）。他依赖血小板输血，尽管接受了由环孢素A、抗胸腺细胞球蛋白和合成代谢类固醇组成的免疫抑制治疗，但仍发生了两次危及生命的颅内出血。他接受了来自HLA匹配同胞的脐带血和骨髓联合造血干细胞移植（hSCT）。预处理方案包括环磷酰胺（CY）200mg/kg和7Gy全身淋巴照射（TLI）。骨髓迅速植入，且无明显移植物抗宿主病（GVHD）。