摘要
12例接受造血干细胞移植治疗的重型 β地中海贫血患儿 ,年龄从 2 5岁～ 11 5岁 ,男 8例 ,女 4例。其中脐血移植 (UCBT) 8例 ,外周血干细胞移植 (PBSCT) 4例。病人以配对方法分为 2组进行观察。A组病人于移植后 +1天起用 (8～10 ) μg/kg·dG -CSF(格兰诺赛特 ) ,B组则于移植后 +5天起使用 ,剂量同上。A组患者获得的有核细胞 (NC)UCB平均为 8 2× 10 7/kg ,PBSC 5 1× 10 8/kg ;B组相对为 5 8× 10 7/kg和 12 5× 10 8/kg。两组的预处理方法基本相同 ,包括马利兰 (14～ 2 0 )mg/kg ,环磷酰胺 (16 0～ 2 0 0 )mg/kg和抗淋巴细胞球蛋白 (90～ 110 )mg/kg。 8例加马法兰 90mg/m2 ,另 2例改为噻替哌 6mg/kg和氟达拉宾 15 0mg/m2 。两组的植入例数均为 5例 ,脱地贫状态生存均为 4例。但中性粒细胞 (ANC)≥ 0 5× 10 9/L时间A组为13 3天 ,B组为 17 9天 ;血小板计数 (PLT) >2 0× 10 9/L时间A组为 2 2天 ,B组为 5 1天 ;植入后不依赖红细胞输注的时间A组(n =4)为 15 5天 ,B组 (n =4)为 44天。两组在重建造血前均发生了感染。G
Twelve (8 males and 4 females) patients with β-thalassemia major received the hematological stem cell transplantation (HSCT). Of 8 cases were umbilical coral blood transplantation (UCBT), the others were peripheral blood stem cell transplantation (PBSCT). The patient's ages ranged from 2 1/2 to 11 1/2 years old all were sibling donors. Of 9 were HLA-identical, 3 were one to three loci mismatched. Put them into 2 groups by match method for observation. The patients in group A began to use G-CSF 8～10 μg/kg.d at day 1 post transplant meanwhile the group B at day 5. The patients received a median UCB nucleated cells(NC) of 8.2×10 7/kg body weight or PBSC NC of 5.1×10 8/kg in group A, While the others were UCB NC of 5.8×10 7/kg or PBSC NC of 12.5×10 8/kg in group B. The conditioning regimen was similar in two groups. It consisted of busalphan 14～20 mg/kg cyclophosphamide 160～200mg/kg and anti-lymphocyte globulin 90～110mg/kg. Malphalan of 90 mg/m 2 was added in 8 cases. Fludarabine 150 mg/m 2 and thiotepa 6 mg/kg were added in another 2 cases. 5 of 6 cases were engrafted in both two groups respectively. The rate of ex-thalassemia was 4/6 in both two groups. However, the median time to reach an absolute neutrophil count (ANC) ≥0.5 ×10 9/L was 13.3 days in group A, 17.9 days in group B on the contrary. The platelet ≥ 20 ×10 9/L was day 22 post transplant in group A but day 51 in group B. The time of independent-infusion of red blood cells in engrafted patients was day 15.5 and day 44 respectively in two groups. The infection occurred both two groups before hematological reconstruction. In brief, G-CSF has the effect to enhance the hematological reconstruction on HSCT.
出处
《中国优生与遗传杂志》
2002年第5期1-3,共3页
Chinese Journal of Birth Health & Heredity
基金
美国中华医学基金会 (CMB) 96 6 30
