摘要
目的分析异体造血干细胞移植前加用抗T淋巴细胞球蛋白（ATG）预防移植物抗宿主反应（GVHD）的疗效。方法27例白血病患者分为两组，每组移植供体来源及病种类似，分别有同胞兄妹、无关供体和人类白细胞抗原（HLA）半相合供体。A组（n=12）：采用经典的CsA＋MTX预防GVHD；B组（n=15）：采用CsA＋MTX＋ATG预防GVHD。结果B组15例患者全部存活，除4例出现Ⅱ°急性GVHD（aGVHD）外，其余11例均在移植后30d左右仅出现Ⅰ°GVHD，并很快控制。A组12例患者中，3例HLA半相合移植患者分别在移植后第7、9和10天即出现Ⅳ。超急性GVHD，另有1例无关供体患者出现Ⅲ°aGVHD，该4例患者由于重度GVHD继发肺部感染而死亡；其余8例同胞之间的移植分别出现Ⅱ°～Ⅲ°aGVHD。结论在异体造血干细胞移植前应用ATG可以有效预防GVHD的发生或减轻GVHD的严重度，明显减少移植相关死亡率。
To analyze effects of antithymocyte globulin （ATG） in preventing the occurrence of graft-versus-host disease （GVHD） in allogeneic stem cells transplantation. Methods Twenty-seven patients with leukemia were divided into two groups. The source of the transplantation donor and the type of acute leukemia were similar between the two groups, including HLA-sibling donors, HLA-unrelated donors and HLA-haploidentical donors. The 12 patients in group A adopted the classic method （ CsA ＋ MTX） to prevent GVHD. The 15 patients in group B adopted CsA ＋ MTX ＋ ATG to prevent the occurrence of GVHD. Results The 15 patients in group B have been all survived. Four of them presented Ⅱ°acute GVHD （aGVHD） , while the rest 11 patients only presentedⅠ°GVHD in approximately 30 d after transplantation with control very soon. In group A, IV ~ ultra-acute GVHD occurred in 3 HLA-haploidentical patients at day 7, 9 and 10 after transplantation. One HLA-unrelated patient presentedⅢ° aGVHD. The 4 patients above mentioned died due to pulmonary infection secondary to severe GVHD. The rest 8 HLA-sibling patients presented Ⅱ°～Ⅲ°aGVHD. Conclusion Using ATG before allogeneic stem cells transplantation can efficiently prevent the occurrence of GVHD or relieve its severity. It can significantly diminish the transplantation related mortality rate.
出处
《上海交通大学学报（医学版）》
CAS
CSCD
北大核心
2007年第8期1011-1013,共3页
Journal of Shanghai Jiao tong University:Medical Science
