Amemiya H, Suzuki S, Ota K, Takahashi K, Sonoda T, Ishibashi M, Omoto R, Koyama I, Dohi K, Fukuda Y
National Cardiovascular Center, Osaka, Japan.
Transplantation. 1990 Feb;49(2):337-43.
The present multicentral clinical study performed in 6 institutes demonstrated that the novel immunosuppressive agent, 15-deoxyspergualin (DSG), is very effective on rejection. In 34 cases of rejection, 30 were treated with DSG at 40 mg/m2 (1 case), 80 mg/m2 (7 cases), 120 mg/m2 (9 cases), 180 mg/m2 (9 cases), and 220 mg/m2 (8 cases). The overall remission rate was 79% in 34 cases of rejection including accelerated, acute, and chronic rejection in different periods after transplantation. Analyzing the remission rates of early phase acute rejection occurring within 3 months after transplantation according to treatment pattern, the remission rate was 100% in 3 cases treated with DSG alone (using DSG 1 week or longer after other agents), 88% in 8 cases treated by rescue use of DSG (using DSG within 1 week after other agents), and 86% in 7 cases treated by combined use of DSG with other agents. Adverse reactions included reductions in WBC and platelets, anemia, perioral numbness, gastrointestinal troubles, and others. However all these symptoms were so mild that DSG treatment was not discontinued. Further studies are necessary on the effect of DSG, especially in acute rejection under conditions that reduce the many influences of other agents as much as possible.
在6家机构开展的这项多中心临床研究表明，新型免疫抑制剂15-去氧精胍菌素（DSG）对排斥反应非常有效。在34例排斥反应病例中，30例接受了DSG治疗，剂量分别为40mg/m²（1例）、80mg/m²（7例）、120mg/m²（9例）、180mg/m²（9例）和220mg/m²（8例）。在34例包括移植后不同时期加速性、急性和慢性排斥反应的病例中，总体缓解率为79%。根据治疗方式分析移植后3个月内发生的早期急性排斥反应的缓解率，单独使用DSG治疗的3例（在使用其他药物1周或更长时间后使用DSG）缓解率为100%，抢救性使用DSG治疗的8例（在使用其他药物1周内使用DSG）缓解率为88%，DSG与其他药物联合使用治疗的7例缓解率为86%。不良反应包括白细胞和血小板减少、贫血、口周麻木、胃肠道不适等。然而，所有这些症状都很轻微，并未停用DSG治疗。有必要进一步研究DSG的疗效，尤其是在尽可能减少其他药物多种影响的条件下对急性排斥反应的疗效。
