急性白血病半相合外周血造血干细胞移植后发生单纯肠道aGVHD的影响因素及治疗转归

发布时间：2018-02-16 11:53

  本文关键词： 急性白血病 半相合外周血造血干细胞移植 肠道移植物抗宿主病　出处：《中国实验血液学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:观察急性白血病半相合外周血造血干细胞移植后影响单纯肠道aGVHD发生的危险因素及治疗转归。方法:回顾性分析我院2010年1月至2016年12月期间行半相合外周血造血干细胞移植的19例急性白血病患者的临床资料,探究发生与未发生肠道aGVHD患者的临床特征差异,单因素分析患者性别、供受者性别差异、供者年龄、预处理方案、兔抗人胸腺细胞免疫球蛋白用量、回输的单个核细胞计数及CD34~+细胞计数对肠道aGVHD发生的影响。观察发生肠道aGVHD患者治疗后的临床转归。结果:19例患者中5例于移植后发生肠道aGVHD(Ⅱ级1例,Ⅲ级3例,Ⅳ级1例),发生时间分别为移植后7,22,27,70和154 d。单因素分析显示,患者性别、供受者性别差异、供者年龄、兔抗人胸腺细胞免疫球蛋白用量、回输的单个核细胞计数及CD34~+细胞计数与肠道aGVHD的发生无相关性,BuCy预处理方案同肠道aGVHD的发生可能相关(P0.05)。5例患者中2例经甲强龙1 mg/(kg·d)治疗后好转,1例患者应用甲强龙联合他克莫司治疗后好转,其余2例患者对激素耐药,应用含CD25单克隆抗体的免疫抑制方案治疗后好转。结论:半相合外周血造血干细胞移植中BuCy预处理方案可能对移植后肠道aGVHD的发生有一定的影响,需要扩大病例数进一步观察确定。
[Abstract]:Objective: to observe the risk factors and therapeutic outcome of simple intestinal aGVHD after haploidentical peripheral blood stem cell transplantation in patients with acute leukemia. Methods: from January 2010 to December 2016, we retrospectively analyzed the risk factors of haploidentical hematopoietic stem cell transplantation in our hospital. Clinical data of 19 patients with Acute Leukemia after Peripheral Hematopoietic Stem Cell Transplantation, To explore the difference of clinical characteristics between patients with and without intestinal aGVHD, univariate analysis of gender, donor gender difference, donor age, preconditioning protocol, rabbit anti-human thymocyte immunoglobulin dosage, The effects of mononuclear cell count and CD34 ~ cell count on intestinal aGVHD were observed. Results 5 of 19 patients with intestinal aGVHD developed intestinal aGV HD (grade 鈪，

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