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[环孢素用于接受异基因骨髓移植的成人移植物抗宿主病的预防]

[Cyclosporine as prophylaxis for graft versus host disease in adults undergoing allogeneic bone marrow transplantation].

作者信息

Matsushita T, Akatsuka Y, Towatari M, Takeyama K, Miyamura K, Sugihara T, Minami S, Kodera Y

出版信息

Rinsho Ketsueki. 1989 Apr;30(4):429-36.

PMID:2671437
Abstract

Fifteen adult patients undergoing allogeneic bone marrow transplantation (BMT) received cyclosporine (CSP) as prophylaxis of graft versus host disease (GVHD). In our patients eleven were hematologic malignancies, and four were severe aplastic anemia. Twelve patients were HLA-matched, and three were one locus mismatched. Three patients received CSP only, twelve received CSP and short term methotrexate. Seven patients had acute GVHD, but GVHD over Grade II were seen in only 3 patients who were transplanted from HLA-one locus mismatched donor. 7 patients had chronic GVHD. CSP were given intravenously at 3-5 mg/kg, starting 1 day before BMT. From about day 30, CSP was given orally. CSP concentrations when patients were given orally were lower in patients who had chronic GVHD. Although hypertension and water retention were seen in 8 patients, and renal dysfunction was seen in 3 patients, the side effects of CSP were mild and transient. There were no correlations between serum concentrations and the side effects of CSP. Three patients had the disturbance of hematopoiesis. Ten of fifteen patients are alive at median follow-up of 18.5 months (8-41 months) after BMT.

摘要

15例接受异基因骨髓移植(BMT)的成年患者接受环孢素(CSP)预防移植物抗宿主病(GVHD)。在我们的患者中,11例为血液系统恶性肿瘤,4例为重型再生障碍性贫血。12例患者HLA配型相合,3例为一个位点不相合。3例患者仅接受CSP,12例接受CSP和短期甲氨蝶呤。7例患者发生急性GVHD,但仅3例从HLA一个位点不相合供体移植的患者出现Ⅱ级以上GVHD。7例患者发生慢性GVHD。CSP于BMT前1天开始静脉注射,剂量为3 - 5mg/kg。从大约第30天起改为口服。发生慢性GVHD的患者口服CSP时的血药浓度较低。虽然8例患者出现高血压和水潴留,3例出现肾功能不全,但CSP的副作用轻微且为一过性。血药浓度与CSP的副作用之间无相关性。3例患者出现造血功能障碍。15例患者中有10例在BMT后中位随访18.5个月(8 - 41个月)时存活。

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