摘要
目的：探讨自体外周血造血干细胞移植（APBSCT）治疗难治性系统性红斑狼疮（SLE）的临床疗效。方法：用APBSCT治疗4例难治性SLE。干细胞动员应用环磷酰胺（CTX）4g／m^2，分两天应用和粒细胞集落刺激因子（GCSF）5～10μg/kg·d^-1；预处理方案包括CTX（50mg／kg·d^-1，-6、-5、-4、-3d），抗胸腺细胞球蛋白（ATG15～20mg／kg·d^-1，-2、-1、＋1、＋2d）。结果：4例患者均获得造血重建，中性粒细胞〉0．5×10^9／L，血小板〉20×10^9／L的中住数时间分别是9d，10d；SLE的临床表现明显减轻，尿蛋白减少或消失，自身抗体转阴或滴度减低，泼尼松用量〈10mg／d；无移植相关死亡。结论：APBSCT治疗难治性SLE近期疗效显著，造血重建恢复迅速，安全有效，远期疗效尚需进一步观察。
Objective： To investigate the efficacy of autologous peripheral blood stem cell transplantation （APBSCT） in treatment of refractory systemic lupus erythematosus （SLE）. Methods. Four patients with refractory SLE received APBSCT. Peripheral stem cells were mobilised with CTX （4g/m^2） and G-CSF （5-10μ/kg·d^-1 ）. Preparative regimen consisted of CTX （50 rng/kg·d^-1 , - 6d, - 5d, - 4d, - 3d） plus antithymocyte globulin（ATG 15-20 mg/kg·d^-1 , - 2d, - 1d, ＋ 1d, ＋ 2d）. Results： The hematopioetic reconstitution of the 4 patients was successful after APBSCT. The median time for granulocyte count 〉0. 5 × 10^9 / L was 9 days, and for plateht 〉20×10^9/L was 10 days. The clinical manifestations of the patients improved obviously after transplantation. The proteinuria decreased or disappeared, and the autoantibodies decreased or became negative. The dosage of prednisone was less than 10 mg/d. There was no transplantation related mortality. Conclusion： APBSCT for refractory SLE shows remarkabh short-term effecL Hematopoietic reconstitution soon recover. It is safe and effective, but the long-term effects have to be observed.
出处
《内科急危重症杂志》
2006年第4期167-169,共3页
Journal of Critical Care In Internal Medicine
关键词
系统性红斑狼疮
造血干细胞移植
Systemic lupus erythematosus Hematopoietic stem cell transplantation
