【摘要】 目的:比较2种移植物抗宿主病(GVHD)预防方案在非血缘造血干细胞移植中的疗效。方法:40例接受非血缘造血干细胞移植患者分成2组。单抗组:27例患者接受环孢素A(CsA)加霉酚酸酯(MMF)加甲氨喋呤(MTX)加抗人胸腺细胞球蛋白(ATG)加CD25单抗预防GVHD;ATG组:13例患者接受CsA加MMF加MTX加ATG预防GVHD。结果:①单抗组和ATG组中性粒细胞植入时间分别为(14.67±4.08)d和(14.53±3.30)d,血小板植入时间分别为(23.83±11.69)d和(23.33±12.01)d,均差异无统计学意义(均P>0.05)。②急性GVHD发生率在单抗组和ATG组分别为25.9%和23.1%,差异无统计学意义(P>0.05);Ⅱ～Ⅳ度急性GVHD累积发生率分别为11.1%和15.3%,差异无统计学意义(P>0.05);慢性GVHD发生率分别为29.6%和0,差异有统计学意义(P<0.05);2组患者广泛型慢性GVHD发生率分别为11.1%和0,差异无统计学意义(P>0.05)。③复发率在单抗组和ATG组分别为25.9%和23.1%,差异无统计学意义(P>0.05)。④预期2年总生存率分别为48.15%和61.54%,2年无病生存率分别为44.4%和53.8%,差异无统计学意义(P>0.05)。结论:非血缘造血干细胞移植中采用CsA加MTX加MMF加ATG的四联GVHD预防方案是一种可取的方案。更多还原

【Abstract】 Objective:To compare the efficacy of two graft versus-host disease(GVHD) prophylaxis regimens in unrelated donor hematopoietic stem cell transplantation(URD-HSCT).Method:Forty patients who received URD-HSCT were divided into two groups.Twenty-seven patients received cyclosporine A,mycophenolate mofetile,short-term methotrexate,antithymocyte globulin(ATG) and CD25 monoclonal antibody(mAb) as GVHD prophylaxis regimen.Thirteen patients received cyclosporine A,mycophenolate mofetil,short-term methotrexate and ATG as GVHD prophylaxis regimen.Result:①The recovery time of neutrophil in CD25 mAb group and ATG-group was(14.67±4.08) days and(14.53±3.30) days,respectively(P>0.05).The recovery time of platelet in CD25 mAb group and ATG-group was(23.83±11.67)days and(23.33±12.01) days,respectively(P>0.05).②The incidence of acute GVHD in CD25 mAb group and ATG-group was 25.9% and 23.1%,respectively(P>0.05).The incidence of grade Ⅱ-Ⅳ acute GVHD in CD25 mAb group and ATG-group was 11.1% and 15.3%,respectively(P>0.05).The incidence of chronic GVHD in two groups was 29.0% and 0%,respectively(P<0.05).The incidence of extensive chronic GVHD in two groups was 11.0% and 0%,respectively(P>0.05).③The incidence of relapse in two groups was 25.9% and 23.1%,respectively(P>0.05).④The estimated 2 year overall survival in two groups was 48.15% and 61.54%,respectively(P>0.05).The estimated 2 year disease free survival in two groups was 44.4% and 53.8%,respectively(P>0.05).Conclusion:The combination of cyclosporine A,mycophenolate mofetil,short-term methotrexate and ATG was a preferable GVHD prophylaxis regimen in URD-HSCT.更多还原