摘要
目的探讨使用兔抗人胸腺细胞免疫球蛋白(ATG)治疗重型再生障碍性贫血(SAA)的疗效及毒副反应。方法回顾性分析2004-2009年共25例SAA患儿应用ATG+环孢素A+雄激素治疗后随访半年以上的疗效。观察患儿血象变化、远期克隆性改变、感染。结果 ATG治疗半年后25例患儿中17例(68%)有效,其中5例(20%)基本治愈,3例(12%)缓解,9例(36%)明显进步,8例(32%)无效中2例(8%)行异基因造血干细胞移植后治愈,2例(8%)半年后因感染死亡。随访期间1例SAA-II型发生远期克隆性改变转变为MDS。1例患儿在输注ATG过程中出现皮疹、发烧、关节痛;2例出现喉头水肿;输注后2周内患儿出现血清病反应,表现为皮疹、发热、关节痛。第1周7例,第2周1例。结论本组患儿用ATG+环孢素A+雄激素治疗有效率68%。毒副作用主要表现为发热、皮疹、关节痛,极少数出现喉头水肿,ATG使用过程中出现的过敏反应及使用后出现的血清病反应均可获得较好控制。
Objective To evaluate the effects and side effects of Antithymocyte globulin（ATG） to treat children with severe aplastic anemia（SAA）.Methods The therapeutic effects of 25 children with SAA treated by Antithymocyte globulin were analyzed retrospectively from 2004 to 2009.Peripheral hemogram,long-term clone change and infection were observed after treatment for more than 6 months.Results ATG were effective in 17 children（68%）.Among them,five（20%） cases were nearly cured,three（12%） got remission and nine（36%） got improved.Eight（32%） cases had no response to ATG treatment.Among them,two（8%） cases were cured after receiving allogeneic hematopoietic stem cell transplantation and two（8%） died because of infection after 6 months.One（4%） case had a clone change into MDS.One case（4%） got rash,fever and joint pain and two cases（8%） got laryngeal edema during ATG infusion.Some children had serum reaction in two weeks after ATG infusion.ConclusionThe effective rate of ATG was 68%.The side effects of ATG included rash,fever and joint pain.Laryngeal edema was rare.Corticosteroid hormone should be considered to prevent allergic and serum reactions during ATG treatment.
出处
《中国小儿血液与肿瘤杂志》
CAS
2011年第2期82-85,共4页
Journal of China Pediatric Blood and Cancer
