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低剂量吗替麦考酚酯联合环孢素和甲氨蝶呤预防异基因造血干细胞移植后移植物抗宿主病。

Combination of low-dose mycophenolate mofetil with cyclosporine and methotrexate as GVHD prophylaxis in unrelated donor allogeneic stem cell transplantation.

机构信息

Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People's Republic of China.

出版信息

Leuk Res. 2013 Sep;37(9):1046-51. doi: 10.1016/j.leukres.2013.06.016. Epub 2013 Jul 10.

Abstract

We report the results of HLA-matched unrelated donor allogeneic stem cell transplantation with new GVHD prophylaxis regimen consisted of cyclosporine, methotrexate and low-dose mycophenolate mofetil in 139 patients with hematologic malignancies. The incidence of grades II-IV and III-IV acute GVHD were 43.0% and 17.3%, respectively. The incidence of chronic GVHD was 42.1%, with 16.5% extensive grade. The cumulative incidence of transplant-related mortality at 100 days and 3 years were 7.9% and 29.7%, respectively. Three-year overall survival, disease-free survival and relapse incidence were 58.7%, 55.3% and 19.6%, respectively. These results suggest the new regime may be effective for the prophylaxis of acute and chronic GVHD in unrelated donor transplantation.

摘要

我们报告了 139 例血液系统恶性肿瘤患者接受 HLA 匹配的无关供体异基因造血干细胞移植,新的移植物抗宿主病预防方案包括环孢素、甲氨蝶呤和低剂量吗替麦考酚酯。Ⅱ-Ⅳ级和Ⅲ-Ⅳ级急性移植物抗宿主病的发生率分别为 43.0%和 17.3%。慢性移植物抗宿主病的发生率为 42.1%,其中 16.5%为广泛性。100 天和 3 年的移植相关死亡率累积发生率分别为 7.9%和 29.7%。3 年总生存率、无病生存率和复发率分别为 58.7%、55.3%和 19.6%。这些结果表明,新方案可能对无关供体移植中急性和慢性移植物抗宿主病的预防有效。

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