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单倍体造血干细胞移植治疗阵发性睡眠性血红蛋白尿症的临床疗效(附1例报告)
  • ISSN号:1002-266X
  • 期刊名称:《山东医药》
  • 时间:0
  • 分类:R556.6[医药卫生—血液循环系统疾病;医药卫生—临床医学;医药卫生—内科学]
  • 作者机构:郑州大学第一附属医院,郑州450052
  • 相关基金:国家自然科学基金资助项目(81070445);河南省医学科技攻关计划项目(201403029)
中文摘要:

目的观察单倍体造血干细胞移植治疗阵发性睡眠性血红蛋白尿症(PNH)的疗效。方法 1例男性43岁PNH患者,行单倍体造血干细胞移植。预处理方案为非清髓的氟达拉滨/环磷酰胺+抗人T细胞兔免疫球蛋白方案;移植物抗宿主病(GVHD)预防采用环孢素A+吗替麦考酚酯+短程甲氨蝶呤方案;肝静脉阻塞病预防采用前列地尔、复方丹参注射液;单倍体造血干细胞供者为其子,患者移植单个核细胞6.51×108/kg,CD34+细胞4.62×106/kg。移植后检测血常规、肝功能,采用糖水试验、Ham's试验观察溶血情况,用流式细胞术监测外周血细胞表面的CD55、CD59及嗜水气单胞菌溶素变异体(FLAER),抽取骨髓液进行骨髓细胞学及染色体检查。结果患者移植后第15天中性粒细胞〉0.5×109/L;移植后第19天血小板〉20×109/L;移植后第35天糖水试验、Ham's试验均转阴,CD55、CD59、ELAER检测结果均正常。随访406 d,患者血常规、骨髓象检查正常,未发生急性GVHD,有慢性皮肤GVHD(局限性)。结论本例PNH患者经单倍体造血干细胞移植治疗后造血功能稳定重建。

英文摘要:

Objective To observe the effect of human leukocyte antigen( HLA) haplo-hematopoietic stem cell transplantation in treatment of patient with paroxysmal nocturnal hemoglobinuria( PNH). Methods A 43-year-old male patient with PNH received haploidentical hematopoietic stem cell transplantation. The conditioning regimen was Fludarabine/cyclophosphamide( Flu/Cy) + anti-human T lymphocyte rabbit immunoglobulin( ATG-fresen). Prophylaxis of GVHD was performed with cyclosporine( CsA),mycophenolate mofetil( MMF) and short-term methotrexate( MTX). Alprostadil and Fufang Danshen injection was use to prevent hepatic veno-occlusive disease. The patient received 6. 51 × 108 mononucleated cells / kg and 4. 62 × 106CD34+cells / kg. The blood routine and liver function after transplantation were detected,and the hemolysis was observe by using sucrose hemolysis test and Ham 's test. Using flow cytometry to monitor CD55 and CD59 on the surface of peripheral blood cells as well as FLAER loss rate. The bone marrow liquid was extracted to do bone marrow cytology and chromosome examination. Results On day 15 and 19 after transplantation,the neutrophils reached 0. 5 ×109/ L and the platelets reached 20 × 109/ L. Ham test and sucrose hemolysis test were negative,and CD55,CD59,FLAER were normal on day 35 after transplantation. The patient had no acute GVHD,but limited chronic skin GVHD developed. At the last follow-up of 406 days,the patient showed normal hemogram and myelogram. Conclusion Haploidentical hematopoietic stem cell transplantation is successful and safe in treatment of PNH,which indicats persistent hematopoietic reconstitution.

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期刊信息
  • 《山东医药》
  • 北大核心期刊(2014版)
  • 主管单位:山东省卫生和计划生育委员会
  • 主办单位:山东卫生报刊社
  • 主编:邱源
  • 地址:济南市燕东新路6号山东卫生报刊社
  • 邮编:250014
  • 邮箱:sdyy88516158@163.com
  • 电话:0531-88957404
  • 国际标准刊号:ISSN:1002-266X
  • 国内统一刊号:ISSN:37-1156/R
  • 邮发代号:24-8
  • 获奖情况:
  • 2009年第四届华东地区优秀期刊、2000年山东省自然...
  • 国内外数据库收录:
  • 美国化学文摘(网络版),英国农业与生物科学研究中心文摘,波兰哥白尼索引,美国剑桥科学文摘,中国中国科技核心期刊,中国北大核心期刊(2004版),中国北大核心期刊(2008版),中国北大核心期刊(2014版),中国北大核心期刊(2000版)
  • 被引量:98858