Am J Hematol:异基因造血干细胞移植治疗前的调理治疗

2020-10-06 MedSci原创 MedSci原创

再生障碍性贫血(AA)的最佳移植前条件仍不清楚。我们对成年AA患者从有血缘关系或无血缘关系的供体进行异基因移植进行了前瞻性研究。我们评估了降低剂量的环磷酰胺(CY)是否能在维持移植的同时降低毒性,以及

再生障碍性贫血(AA)的最佳移植前条件仍不清楚。我们对成年AA患者从有血缘关系或无血缘关系的供体进行异基因移植进行了前瞻性研究。我们评估了降低剂量的环磷酰胺(CY)是否能在维持移植的同时降低毒性,以及低剂量胸腺球蛋白是否能安全地预防移植物抗宿主病(GVHD)。

移植前预处理方案包括氟达拉滨120 mg/m2 ,CY 100 mg/kg,胸腺球蛋白2.5 mg/kg,有或没有2 Gy全身照射。分析了27名中位年龄为36岁的患者。

 

结果,16名患者接受了亲属捐赠者的移植。26名患者的干细胞来源为骨髓。除一名早逝的患者外,所有患者均在中位期19天时实现了中性粒细胞的移植。6名和5名患者分别在30天和90天时观察到混合嵌合体。只有一名患者经历了完全供体型嵌合的二次移植失败。没有一位患者出现严重的急性GVHD。1年时慢性GVHD的累计发生率为37.7%。1年和3年的总生存率为96.3%。1例患者在60天时检测到EB病毒-DNA载量较高。1年内无一人发生EBV-淋巴增生症。

 

综上所述,该研究结果表明,本研究中的条件方案是安全有效的。但慢性GVHD的发生率相对较高,需要进一步改进。

 

原始出处:

 

Shinichi KakoYoshinobu Kanda, et al., Allogeneic hematopoietic stem cell transplantation for aplastic anemia with pre-transplant conditioning using fludarabine, reduced-dose cyclophosphamide, and low-dose thymoglobulin: A KSGCT prospective study. Am J Hematol. 2020 Mar;95(3):251-257. doi: 10.1002/ajh.25693. 

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    2020-10-26 琴天

    题目翻译有误!调理治疗应该改为预处理方案!

    0

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    2020-10-09 独孤立克

    干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦

    0

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    2020-10-08 jacob9231

    学习了 谢谢

    0

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    2020-10-08 fengyi812
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    2020-10-08 俅侠

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再生障碍性贫血(AA)的特点为全血细胞减少和骨髓造血功能衰竭,重型患者起病急,病情进展迅速,如不能得到及时有效治疗,患者常死于严重的出血或感染。经过多年的临床探索,其诊断和治疗水平已经明显提高。自2010年我国制定第1版AA诊治专家共识至今,已历时6年,关于该疾病的诊疗,已经发生了一些变化。为进一步更好地指导我国临床医生对AA的诊疗工作。2016年中华医学会血液学分会红细胞疾病(贫血)学组对原版专

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患者女,25 岁,因反复口腔溃疡 5 年,双下肢结节 性红斑 3 个月,双下肢疼痛 10 d,于 2016 年 11 月 02 日收治我院。患者 5 年前无明显诱因出现反复口腔黏膜 疼痛性溃疡,大于 3 次/年,可自愈,不留瘢痕,未予重 视,疼痛加重时于当地诊所静脉输液治疗(具体不详)。 3 个月前患者双下肢出现多发结节性红斑(图 1),

病例:阿扎胞苷有效治疗1例再生障碍性贫血转骨髓增生异常综合征

骨髓增生异常综合征(MDS)是一组临床表现、自然病程和预后差异性很大的疾病。诊断需依赖血细胞计数、形态学、细胞遗传学等相关信息,部分患者存在诊断及和再生障碍性贫血等疾病鉴别诊断困难,临床中需仔细分析,详细排查,密切随访。一旦考虑诊断成立,应按照预后分组同时结合患者年龄、体能状况、合并疾病、治疗依从性等进行综合分析,选择治疗方案。

Blood:再生障碍性贫血患者,进行造血干细胞移植后感染相关的死亡风险与供体的端粒酶长度相关!

中心点:供体端粒酶长可减少重度再生障碍性贫血患者进行造血干细胞移植后感染相关的死亡。摘要:既往研究表明长的供体白细胞端粒长度(TL)与重度再生障碍性贫血(SAA)患者进行造血干细胞移植(HCT)后的存活率提高相关。现Shahinaz M. Gadalla等人对细胞特异性淋巴细胞的TL是否与HCT后特定原因的死亡相关进行探究。通过流式细胞术和原位杂交荧光(flow FISH)对供体总体的淋巴细胞TL

Blood:艾曲波帕(EPAG)与难治性重度再生障碍性贫血(rSAA)

基于43位患者治疗12周(50-150mg)的效果,艾曲波帕(EPAG)获得FDA批准用于治疗难治性重度再生障碍性贫血(rSAA)。反应动力学表明延长EPAG(150mg)的给药时间可加速反应速度,提高缓解率。研究人员招募了40位rSAA患者,EPAG 150mg/日,主要评估指标是24周时的缓解率。24周时,有20位(50%)患者获得缓解,其中5位(25%)在12周时被认为是无反应者。15/19