Zhang Yu, Ye Bao-Dong, Qian Li-Li, Gao Yan-Ting, Wen Xiao-Wen, Shen Jian-Ping, Zhou Yu-Hong
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2015 Jan;35(1):53-6.
To evaluate the clinical efficacy of treating myelodysplastic syndrome (MDS) by hematopoietic stem cell transplantation (HSCT) combined with Chinese medical syndrome typing.
From July 2009 to July 2013, 6 MDS patients were treated with allo-HSCT combined with Chinese medical syndrome typing from HLA-identical sibling donors at Department of Hematology, Zhejiang Provincial Hospital of Chinese Medicine. Patients were classified as refractory anemia (RA, 2 cases), refractory anemia with ringed sideroblast (RARS, 1 case), refractory cytopenia with multilineage dysplasia (RCMD, 2 cases), and RA with excess blasts-I (RAEB-I , 1 case). Modified BuCy conditioning regimen was used in all 6 cases. Two patients received bone marrow transplantation (BMT), 1 patient received peripheral blood stem cell transplantation (PBSCT), and 3 patients received BMT + PBSCT. In order to prevent the occurrence of graft-versus-host disease (GVHD), all patients were treated with cyclosporine + methotrexate + mycophenolate mofetil. Different Chinese medical treatment methods (by syndrome typing) were given to patients according to different criticality of international prognostic scoring system (IPSS, 5 at moderate risk and 1 at high risk).
All 6 patients successfully reconstructed their hematopoietic system. The time from transplantation to ANC ≥ 0.5 x 10(9)/L and platelet (PLT) ≥ 20 x10(9)/L were 13 (9-15) days and 11 (9-22) days respectively. Main complications were GVHD. Acute GVHD (aGVHD) occurred in 4 cases, 3 cases of grade I and 1 case of grade II, and local chronic GVHD (cGVHD) occurred in 1 patient. All cases survived with median follow-up of 18 (11-58) months. The overall survival (OS) and disease-free survival (DFS) rate were 100%.
HSCT combined with Chinese medical syndrome typing could improve clinical symptoms, reduce transplant as- sociated complications. So it was an effective treatment choice for MDS.
评估造血干细胞移植（HSCT）联合中医辨证分型治疗骨髓增生异常综合征（MDS）的临床疗效。
2009年7月至2013年7月，浙江省中医院血液科对6例MDS患者采用来自HLA全相合同胞供者的异基因HSCT联合中医辨证分型进行治疗。患者分为难治性贫血（RA，2例）、环形铁粒幼细胞性难治性贫血（RARS，1例）、多系发育异常的难治性血细胞减少症（RCMD，2例）和伴有原始细胞增多的难治性贫血-I（RAEB-I，1例）。6例均采用改良BuCy预处理方案。2例患者接受骨髓移植（BMT），1例患者接受外周血干细胞移植（PBSCT），3例患者接受BMT+PBSCT。为预防移植物抗宿主病（GVHD）的发生，所有患者均采用环孢素+甲氨蝶呤+霉酚酸酯进行治疗。根据国际预后评分系统（IPSS）的不同危险度（中危5例，高危1例）给予患者不同的中医治疗方法（辨证论治）。
6例患者均成功重建造血系统。移植至中性粒细胞绝对值（ANC）≥0.5×10⁹/L和血小板（PLT）≥20×10⁹/L的时间分别为13（9-15）天和11（9-22）天。主要并发症为GVHD。急性GVHD（aGVHD）发生4例，其中Ⅰ度3例，Ⅱ度1例，局部慢性GVHD（cGVHD）发生1例。所有病例均存活，中位随访时间为18（11-58）个月。总生存（OS）率和无病生存（DFS）率均为100%。
HSCT联合中医辨证分型可改善临床症状，减少移植相关并发症。因此它是MDS的一种有效治疗选择。
