文章摘要
黄 菲,张 闰,缪扣荣,吴汉新,沈文怡,陆 化.HLA半相合异基因外周血造血干细胞移植治疗AA克隆演变继发MDS疗效分析[J].南京医科大学学报,2018,(9):1269~1274
HLA半相合异基因外周血造血干细胞移植治疗AA克隆演变继发MDS疗效分析
Efficiency and safty of haploidentical hematopoietic stem cell transplantation for myelodysplastic syndrome evolved from aplastic anemia
投稿时间:2018-03-23  
DOI:10.7655/NYDXBNS20180919
中文关键词: 再生障碍性贫血  克隆演变  骨髓增生异常综合征  HLA半相合异基因外周血造血干细胞移植
英文关键词: aplastic anemia  clonal evolution  myelodysplastic syndrome  haploidentical hematopoietic stem cell transplantation
基金项目:国家自然科学基金青年基金(81400079);江苏省卫计委项目(Z201402);江苏省科教强卫工程医学青年人才 (QNRC2016565);江苏省六大人才高峰(WSN?026)
作者单位
黄 菲 南京医科大学第一附属医院血液科江苏 南京 210029 
张 闰 南京医科大学第一附属医院血液科江苏 南京 210029 
缪扣荣 南京医科大学第一附属医院血液科江苏 南京 210029 
吴汉新 南京医科大学第一附属医院血液科江苏 南京 210029 
沈文怡 南京医科大学第一附属医院血液科江苏 南京 210029 
陆 化 南京医科大学第一附属医院血液科江苏 南京 210029 
摘要点击次数: 486
全文下载次数: 570
中文摘要:
      目的:回顾性分析应用HLA半相合异基因外周血造血干细胞移植(haploidentical hematopoietic stem cell transplantation,haplo?HSCT)治疗再生障碍性贫血(aplastic anemia,AA)克隆演变继发骨髓增生异常综合征(secondary myelodysplastic syndrome,sMDS)的疗效和安全性。方法:本中心5例AA患者经强化免疫抑制治疗后演变为sMDS,均采用haplo?HSCT,观察植入情况,移植物抗宿主病(graft versus host disease,GVHD)、移植相关并发症和移植相关病死率(transplant related modify,TRM)、总体生存(overall survival,OS)时间等。结果:5例中位OS时间63个月(41.9~149.3个月),移植后中位OS时间12.9个月(2.4~36.5个月),1年累积生存率60%,TRM 40%。移植后粒系植入时间18 d(14~22 d),血小板植入时间21 d(15~65 d),总植入率100%。60%(3/5)患者发生Ⅰ~Ⅲ度急性移植物抗宿主病(acute graft versus host disease,aGVHD),无Ⅳ度aGVHD发生,20%(1/5)患者发生慢性移植物抗宿主病(chronic graft versus host disease,cGVHD)。中位随访时间63个月(41.9~149.3个月)。结论:在无合适HLA相合供者情况下,haplo?HSCT可作为AA演变MDS患者的有效治疗策略。
英文摘要:
      Objective:To evaluate the efficiency and safety of haploidentical hematopoietic stem cell transplantation(haplo?HSCT)for treatment of secondary myelodysplastic syndrome(sMDS) after AA. Methods:Evaluation of therapeutic effect,incidence rate of aGVHD and cGVHD,complications and overall survival(OS) of 5 AA post MDS patients who received haplo?HSCT in this center,and compared with other treatments for sMDS evolved from AA. Results:Among 5 patients,median OS was 63 months(range from 41.9 to 149.3 months),OS after HSCT was 12.9 months(range from 2.4 to 36.5 months). 1?year event free survival was 60%. All patients achieved neutrophil and platelet engraftment at a median of 18 days(range from 14 to 22 days)and 21 days(range from 15 to 65 days)respectively. 3 occurred Ⅰ~Ⅲ° acute graft versus host disease(aGVHD),and 1 with chronic graft versus host disease(cGVHD). Medial follow?up was 63 months(range from 41.9 to 149.3 months). Conclusion:The haplo?HSCT can be an opition for sMDS from AA patients in case of an HLA?identical donor is not available.
查看全文   查看/发表评论  下载PDF阅读器