摘要
目的:建立一种治疗闭塞性细支气管炎综合症（BOS）的新方案,并初步观察其安全性和有效性。方法:7例HSCT后确诊的BOS病例,分别给予脐带间充质干细胞（MSC）1×106/kg,静脉输注1次/周,4周共4次;阿奇霉素0.25 g口服1次/隔日;布地奈德福莫特罗粉吸入剂4.5μg,3次/天,如患者出现呼吸衰竭,则给予甲泼尼龙1mg/（kg·d）,维持2周,之后激素快速减量,至治疗后4周,甲泼尼龙减至0.25 mg/（kg·d）。之后,根据患者慢性移植物抗宿主病情况,调整激素用量。结果:在治疗过程中未出现严重并发症。除1例患者合并心衰治疗无效死亡外,另外6例患者肺功能指标包括FEV1,FEV1/FVC,PaO2和AaDO2均在6个月后得到显著改善（P<0.05）。结论:MSC联合布地奈德福莫特罗和阿奇霉素治疗BOS是安全的,并可在一定程度上减少激素用量,提高患者的生存质量。
Objective:To evaluate the safety and effectiveness of a novel therapeutic regimen for bronchiolitis obliterans sydrome(BOS) affter hematopoietic stem cell transplantation(HSCT).Methods:Seven patients who had received HSCT and had been diagnosed as BOS were enrolled in this study.They received weekly intravenous injection of umbilical cord-derived mesenchymal stem cells(MSC) at a dose of 1 × 10 /kg for 4 weeks.Budesonide was given orally at a daily dose of 0.25 g,and salmeterol was inhaled at a dose of 4.5 μg for 3 times per day.Methylprednisolone was given at a dose of 1 mg/(kg · d) for 2 weeks when respiratory failure occured.The dose of methylprednisolone was tapered to 0.25 mg/(kg · d) after 4 weeks and was adjusted according to the occurrence and severity of chronic graftversus-host disease(cGVHD).Results:The therapy was generally safe and no severe acute toxicity was observed.One patient died of heart failure during the treatment,the other 6 patients were alive and the pulmonary function parameters including FEV1,FEV1/FVC,PaO_2 and AaDO_2 were significantly improved after 6 months as compared with the baseline parameters(P < 0.05).Conclusion:MSC combined with budesonide,almeterol and azithromycin has been confirmed to be generally safe and can reduce the dose of glucocorticoid in treatment of BOS after HSCT.
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2016年第1期173-177,共5页
Journal of Experimental Hematology
基金
国家自然科学基金(81200405)
关键词
间充质干细胞
闭塞性细支气管炎
糖皮质激素
mesenchymal stem cells
bronchiolitis obliterans syndrome
glucocorticoid
