【摘要】 目的 :研究自体造血干细胞移植治疗血液系统恶性肿瘤过程中环孢素A(CSA)能否诱导移植物抗宿主病(GVHD) ,并确定其毒副反应。方法 :进行自体造血干细胞移植的 10例血液系统恶性肿瘤患者接受CSA静脉滴注1.5mg/ (kg·d) ,0～ 2 8d ,观察皮疹情况、有无腹泻及血清胆红素水平来判断GVHD的发生 ;同时观察移植后造血重建、感染、出血以及检测肝、肾功能来分析其治疗的毒副反应。结果 :2例次早期出现GVHD ,皮疹为 +和 + + ,出现时间分别为移植后 8和 17d ,持续时间较短 ( 4和 5d) ,外周血WBC计数分别为 0 .9× 10 9/L和 0 .2× 10 9/L ;6例次患者出现GVHD皮疹 ( 1例 + ,5例 + + ,不包括前述 2例次 )的时间为 30d( 2 2～ 4 4d) ,皮疹持续时间为 18d( 9～ 2 8d) ,外周血WBC计数为 1.4 5× 10 9/L[( 0 .4～ 2 .6 )× 10 9/L]。对移植后造血重建、感染、出血 ,以及肝、肾功能的影响不明显。结论 :CSA在自体造血干细胞移植过程中可以安全地诱导GVHD的发生 ,但其抗肿瘤效应的证据有待于进一步研究更多还原

【Abstract】 Objective:To investigate if graft_ versus _host disease(GVHD) could be induced by treatment with cyclosporine A(CSA) in patients undergoing autologous hematopoietic stem cell transplantation for hematological malignancies, and define the toxicities of this approach. Methods: Ten cases of hematological malignancies were administrated with intravenous CSA 1.5?mg/(kg·d) 0-28?d following autologous stem cell transplantation.Induction of GVHD was monitored by rashes, diarrhea and jaundice.Toxicities of treatment were assessed by analysis of hematopoietic reconstitution, infection, hemorrhage, hepatic and renal function after_transplantation. Results:GVHD was early induced in 2 cases at 8d and 17?d after transplantation respectively; Rashes were graded + and ++, lasted 4 and 5?d; WBC counts were 0.9×10 9/L and 0.2×10 9/L at onset of GVHD. GVHD of the skin occurred in 6 cases except 2 cases mentioned above(1 case +, 5 cases ++) at 30?d(22-44?d) and lasted 18?d(9- 28?d) ; WBC counts were 1.45×10 9/L[(0.4-2.6)×10 9/L] at onset of GVHD. No negative impact on hematopoietic reconstitution, infection, hemorrhage, hepatic and renal function after transplantation was observed.Conclusions:GVHD can be safely induced by treatment with CSA in patients undergoing autologous hematopoietic stem cell transplantation for hematological malignancies. Further investigation is needed for evidence of antitumor efficacy.更多还原