Armand Philippe, Antin Joseph H
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA.
Biol Blood Marrow Transplant. 2007 May;13(5):505-16. doi: 10.1016/j.bbmt.2007.02.005.
Aplastic anemia encompasses a heterogeneous group of diseases with distinct pathophysiologies and a common clinical endpoint of marrow failure. Patients with severe aplastic anemia can be treated with immunosuppressive therapy (IST) or hematopoietic stem cell transplantation (HSCT). Over the last 30 years, advances in both treatment modalities have significantly improved the prognosis for this disease; yet this evolution complicates the central therapeutic question in aplastic anemia: which patients should receive IST and which ones should receive HSCT as front-line therapy? In this review, we describe the major improvements that have occurred in transplantation for aplastic anemia in the last 3 decades. We then outline a framework for deciding which patients should be considered for upfront transplantation.
再生障碍性贫血包括一组具有不同病理生理机制且共同临床终点为骨髓衰竭的异质性疾病。重型再生障碍性贫血患者可采用免疫抑制治疗（IST）或造血干细胞移植（HSCT）。在过去30年里，这两种治疗方式的进展显著改善了该疾病的预后；然而，这种演变使再生障碍性贫血的核心治疗问题变得复杂：哪些患者应接受IST治疗，哪些患者应接受HSCT作为一线治疗？在本综述中，我们描述了过去30年中再生障碍性贫血移植治疗所取得的主要进展。然后，我们概述了一个用于决定哪些患者应考虑进行前期移植的框架。
