本文關(guān)鍵詞： 急性白血病 半相合外周血造血干細(xì)胞移植 腸道移植物抗宿主病　出處：《中國實(shí)驗(yàn)血液學(xué)雜志》2017年03期 　論文類型：期刊論文

【摘要】：目的:觀察急性白血病半相合外周血造血干細(xì)胞移植后影響單純腸道aGVHD發(fā)生的危險(xiǎn)因素及治療轉(zhuǎn)歸。方法:回顧性分析我院2010年1月至2016年12月期間行半相合外周血造血干細(xì)胞移植的19例急性白血病患者的臨床資料,探究發(fā)生與未發(fā)生腸道aGVHD患者的臨床特征差異,單因素分析患者性別、供受者性別差異、供者年齡、預(yù)處理方案、兔抗人胸腺細(xì)胞免疫球蛋白用量、回輸?shù)膯蝹�(gè)核細(xì)胞計(jì)數(shù)及CD34~+細(xì)胞計(jì)數(shù)對(duì)腸道aGVHD發(fā)生的影響。觀察發(fā)生腸道aGVHD患者治療后的臨床轉(zhuǎn)歸。結(jié)果:19例患者中5例于移植后發(fā)生腸道aGVHD(Ⅱ級(jí)1例,Ⅲ級(jí)3例,Ⅳ級(jí)1例),發(fā)生時(shí)間分別為移植后7,22,27,70和154 d。單因素分析顯示,患者性別、供受者性別差異、供者年齡、兔抗人胸腺細(xì)胞免疫球蛋白用量、回輸?shù)膯蝹�(gè)核細(xì)胞計(jì)數(shù)及CD34~+細(xì)胞計(jì)數(shù)與腸道aGVHD的發(fā)生無相關(guān)性,BuCy預(yù)處理方案同腸道aGVHD的發(fā)生可能相關(guān)(P0.05)。5例患者中2例經(jīng)甲強(qiáng)龍1 mg/(kg·d)治療后好轉(zhuǎn),1例患者應(yīng)用甲強(qiáng)龍聯(lián)合他克莫司治療后好轉(zhuǎn),其余2例患者對(duì)激素耐藥,應(yīng)用含CD25單克隆抗體的免疫抑制方案治療后好轉(zhuǎn)。結(jié)論:半相合外周血造血干細(xì)胞移植中BuCy預(yù)處理方案可能對(duì)移植后腸道aGVHD的發(fā)生有一定的影響,需要擴(kuò)大病例數(shù)進(jìn)一步觀察確定。
[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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