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儿童格雷塞利综合征造血干细胞移植:单中心经验。

Hematopoietic SCT in children with Griscelli syndrome: a single-center experience.

机构信息

Department of Pediatric Hematology/Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.

出版信息

Bone Marrow Transplant. 2010 Aug;45(8):1294-9. doi: 10.1038/bmt.2009.358. Epub 2010 Jan 11.

Abstract

In total, 11 consecutive pediatric patients with Griscelli syndrome (GS) type 2, who received allogeneic hematopoietic SCT (aHSCT) at our center between 1993 and 2007, were reviewed. The median age at transplantation was 8.2 months (range, 4-36.3 months) and the median time from diagnosis to transplantation was 3.7 months (range, 1.4-19.5 months). Seven patients developed an accelerated phase and were treated with chemotherapy before transplantation. At the time of transplantation, all patients were in clinical remission. The source of grafts was matched-related marrows in eight patients and partially mismatched unrelated cords in three patients. All patients were engrafted at a median time of 15 days (range, 12-36 days). Grade I-II acute GVHD and veno-occlusive disease occurred in three and one patient, respectively. A total of 10 patients are now alive and disease free at a median of 4.8 years post-HSCT. The post transplant course was complicated by CMV infection in four patients. One patient died in remission from septic shock, 6 months after transplantation. Chimerism studies at the last contact are available for nine patients: six patients have complete donor chimerism and three have stable mixed chimerism. Early aHSCT from matched-related donors or unrelated cord blood for children with GS is feasible.

摘要

共回顾了 1993 年至 2007 年间在我们中心接受同种异体造血干细胞移植(aHSCT)的 11 例连续的小儿格雷塞利综合征(GS)2 型患者。移植时的中位年龄为 8.2 个月(范围为 4-36.3 个月),从诊断到移植的中位时间为 3.7 个月(范围为 1.4-19.5 个月)。7 例患者在移植前进展为加速期,并接受化疗治疗。移植时,所有患者均处于临床缓解期。8 例患者的移植物来源为匹配相关的骨髓,3 例患者的移植物来源为部分不匹配的无关脐带血。所有患者均在中位时间 15 天(范围 12-36 天)内植入。3 例患者出现 1-2 级急性移植物抗宿主病,1 例患者出现静脉闭塞性疾病。目前,共有 10 例患者在移植后 4.8 年中位时间内无病存活。移植后共有 4 例患者发生 CMV 感染,病程复杂。1 例患者在移植后 6 个月因败血症性休克缓解期死亡。在最后一次随访时,9 例患者可进行嵌合状态研究:6 例患者完全供者嵌合,3 例患者稳定混合嵌合。对于 GS 患儿,从匹配相关供体或无关脐带血进行早期 aHSCT 是可行的。

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