重型再生障碍性贫血的骨髓移植。9例报告。

Bone marrow transplantation for severe aplastic anemia. A report of 9 cases.

作者信息

Marmont A M, Van Lint M T, Avanzi G, Reali G, Adami R, Soldá A, Strada P, Barbanti M, Mingari M C, Soro O, Grazi G, Pedullá D, Cerri R, Rossi E, Giordano D, Santini G, Carella A, Risso M, Vimercati R, Piaggio G, Raffo M R, Librace E, Vitale V, Bacigalupo A

出版信息

Acta Haematol. 1979;62(3):121-7. doi: 10.1159/000207557.

DOI:10.1159/000207557

PMID:43062

Abstract

9 patients with severe aplastic anemia (SAA) were treated with bone marrow transplantation (BMT). 5 were conditioned with cyclophosphamide and received and HLA-identical graft (4 patients) or a mismatched graft (1 patient): 1 rejected the graft on day 30 and died on day 34 during conditioning for a second transplant; 1 died on day 15 with acute and severe graft versus host disease (GvHD) in the absence of haemopoietic engraftment; 3 are alive and complete chimeras at 1,069, 490 and 332 days after transplantation. GvHD developed in 4 patients and was treated successfully in 3 with high dose methylprednisolone and/or antilymphocytic globulin (ALG). 4 patients were conditioned with ALG and received bone marrow from a haploidentical sibling or parent: 1 patient was refractory; 3 patients showed evidence of hematologic reconstitution, but 2 of these required a second course of ALG. 3 patients in this group are alive between 60 and 490 days; 1 patient died on day 121 of HBSAg-negative acute hepatitis.

摘要

9例重型再生障碍性贫血（SAA）患者接受了骨髓移植（BMT）治疗。5例采用环磷酰胺预处理，接受了 HLA 全相合移植（4例患者）或不相合移植（1例患者）：1例在第30天移植排斥，在进行第二次移植预处理期间于第34天死亡；1例在第15天死于急性重度移植物抗宿主病（GvHD），且无造血植入；3例在移植后1069天、490天和332天存活且为完全嵌合体。4例患者发生了GvHD，其中3例采用大剂量甲泼尼龙和/或抗淋巴细胞球蛋白（ALG）成功治疗。4例采用ALG预处理，接受了来自单倍体相合同胞或父母的骨髓：1例患者无效；3例有血液学重建证据，但其中2例需要第二个疗程的ALG。该组3例患者在60至490天之间存活；1例患者在第121天死于HBsAg阴性急性肝炎。