摘要
目的观察重组人白细胞介素11(rhIL-11)加速无血缘关系脐血移植血小板植入的情况。方法 9例患者中成人6例,儿童3例。接受 HLA 0～2个位点不合的脐血移植。成人给予双份脐血移植,儿童给予单份脐血移植。预处理采用 BU/CY 或 CY/TBI 方案,同时加用抗胸腺细胞球蛋白(ATG)。采用环孢素联合短疗程甲氨蝶呤预防移植物抗宿主病(GVHD)。移植后1天开始皮下注射rhIL-11 50 mg·kg^(-1)·d^(-1)和 G-CSF 5 mg·kg^(-1)·d^(-1)促进造血重建。结果 9例患者平均年龄22.3岁,平均体重52.3 kg。9例患者8例白细胞植入,中性粒细胞>0.5×10~9/L 的中位时间为21.3(14～37)天;7例患者血小板植入,血小板>20×10~9/L 的中位时间为25(18～36)天。急性 GVHD(aGVHD)发生率为42.9%,均为Ⅰ度。慢性 GVHD(cGVHD)发生率为33.3%,为局限型。死亡3例,死亡主要原因为感染。存活的6例患者,中位随访时间为7个月,均为无病存活。预计1年总生存率为77.8%,2年总生存率为52.2%。使用 rhIL-11的8例患者中5例(62.5%)出现渗漏综合征。所有患者在采取包括紫草的综合防治措施后均可耐受 rhIL-11的治疗。结论 rhIL-11可能有利于加速血小板的植入,降低严重 aGVHD 的发生率。渗漏综合征是主要的不良反应,在采取包括紫草的综合防治措施后患者耐受较好。
Objective To observe whether rhIL-11 could accelerate the engraftment of platelets after unrelated cord blood transplantation （CBT）. Methods Nine patients （3 children and 6 adults） were enrolled in this study. The degree of HLA disparity was 0 - 2 loci. Cord blood was given two units for adults and one unit for children. Conditioning regimens were CY/TBI in 1 and BU/CY in 8 cases, both with antithymocyte globulin. Graft-versus-host disease（GVHD） prophylaxis consisted of cyclosporine and short-term metho- trexate. On day ＋ 1, rhIL-11 was used at 50 μg · kg^- 1 · d^- 1 and G-CSF at 5 μg · kg^- 1 · d^- 1 to accelerate hematopoiesis recovery. Results The median age of the patients was 22.3 years and the median weight 52.3 kg. Among the 9 patients, 8 （ 88.9% ） experienced engraftment. The median time to neutrophil 〉 0.5 × 10^9/L was 21.3 （14 -37） days and to platelet 〉 20× 10^9/L was 25 （18 -36） days. 42.9% of the patients developed grade I aGVHD and 33.3% developed localized chronic GVHD. Six patients were alive and disease-free at a median follow-up of 7 months. Infection was the primary cause of death. The expected 1-year survival was 77.8% , 2-year survival was 52.2%. Five of 8 patients （ 62.5% ） who received IL-11 presented leakage syndrome. On prophylaxis with drugs containing Arnebia root extract, all patients could tolerate the treatment. Conclusion rhIL-11 maybe helpful for accelerating the platelet recovery and reducing aGVHD severity in unrelated CBT. The major side effect is leakage syndrome. It is well tolerated on prophylaxis with drugs containing Arnebia root.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2007年第8期519-522,共4页
Chinese Journal of Hematology
关键词
胎血
造血干细胞移植
白细胞介素11
紫草
Cord blood
Hematopoietic stem cell transplantation
Interleukin-11
Arnebia root
