【摘要】 目的 :探索异基因外周血造血干细胞移植 (allo -PBSCT)治疗重型再生障碍性贫血 (SAA)的疗效及其长期造血重建 ,分析其治疗过程中移植物抗宿主病 (GVHD)的发生状况 ,探讨其有效治疗方法。方法 :1例SAA患者 ,男性 ,2 6岁 ,供者为其胞妹 ,HLA配型完全相合。预处理采用全身照射 (TBI) +环磷酰胺 (CTX) +抗胸腺细胞球蛋白 (ATG)方案 ;GVHD预防采用常规环胞菌素 ,A(CsA) +短程甲氨蝶呤 (MTX)方案 ;治疗慢性GVHD(cGVHD)采用霉酚酸酯 (MMF) +CsA +硫唑嘌吟 (6 -MP) +泼尼松 +酞咪哌啶酮 (反应停 ,Thalido mide)。结果 :移植后 2 3d造血重建。同时检测染色体核型为 4 6 ,XX(G) ,第 6 3天血型由B型转变为O型。移植 133d发生cGVHD ,随访 2 8个月 ,cGVHD已控制。结论 :异基因外周血造血干细胞移植可有效治疗重型再障 ,本例造血重建迅速 ,cGVHD有效治疗后可被控制。更多还原

【Abstract】 Objective:To report a patient with severe aplastic anemia (sAA) who was successfully treated to analyze the incidence and the effective prevention and treatment of graft-versus host disease(GVHD) for the allogeneic peripheral blood stem cell transplantation (allo-PBSCT).Methods:A 26-year old patient (man) with sAA received allo-PBSCT from a HLA-compatible sibling donor. PBSCs mobilization regimen was G-CSF 250μg/d×5. The conditioning regimens were TBI plus CTX and ATG. 9.405×10 8 uncleated cells/kg, 12.49×10 6 CD 34+cells/kg were transplanted. The regiment was used for prophylaxis of GVHD which was the combination of low dose cyclosporine (CsA) and shot course methotrexate (MTX). cGVHD was treated with the combination MMF, CsA, 6-mp, Prednison and Thalidomide.Results:Hematopoietic reconstitution obtained on 23th day after allo-PBSCT. At the same time, chromosome analysis was showed in the type of 46:XX(G). The chromic GVHD (cGVHD) occurred on 133th day 133 after allo-PBSCT. In the follow-up duration of 28 months, cGVHD was controlled.Conclusions:Allo-PBSCT was an effective therapy for severe aplastic anemia, cGVHD was controlled with effective treatment.更多还原