摘要
为了解自体外周血与骨髓造血干 祖细胞先后双次移植 (SD AHSCT)的安全性与可行性 ,对我科开展的 2 0例SD AHSCT的移植相关并发症及造血重建情况进行了回顾性分析。 2 0例恶性血液病患者的SD AHSCT方案为先行外周血造血干 祖细胞移植 ,再行骨髓移植。结果表明 ,本组所有患者均能耐受所进行的外周血造血干 祖细胞动员、采集和经髂后上嵴大量抽取骨髓 ,并且两次都采集到了足够数量的造血干 祖细胞。SD AHSCT后所有患者均顺利完成造血重建 ,造血重建与回输造血干 祖细胞数量成正相关 (r =0 .96 8) ,且第 1次移植后造血重建速度快于第 2次 (P <0 .0 5 )。两次移植的皮肤、粘膜出血率无明显差异 ,均无患者发生大出血 ,但第 2次移植后血小板输用量多于第 1次移植 (P <0 .0 1)。第 1次移植后口腔溃疡发生率明显高于第 2次 (P <0 .0 1)。SD AHSCT中两次移植的感染发生率、感染部位和感染原无明显差异 (P >0 .10 )。两次移植的移植相关并发症经治疗后均治愈或好转 ,移植相关死亡率为 0。结论 :SD AHSCT安全可行 ,值得总结和进一步推广。
In order to get clinical information about safety and feasibility of successively double autologous hemopoietic stem cell transplants (SD-AHSCT) in malignant hematological disease patients, the complications and hematological reconstitution after SD-AHSCT in 20 patients were analyzed retrospectively. 20 patients with hematologic malignancies received autologous peripheral blood stem/prognitor cell transplantation at the first transplant, and then were given autologous bone marrow transplantation as the second transplant at 4-10 months. The results showed that all the patients tolerated mobilization and collection of peripheral blood stem/prognitor cells as well as bone marrow collection. All the patients got enough hematological stem/prognitor cells for SD-AHSCT and achieved hematological reconstitution after SD-AHSCT. The speed of hematological reconstitution was positively correlated with the transfused quantity of hematological stem/prognitor cells (r=0.968). The hematological reconstitution after the first autologous hemopoietic stem cell transplant (AHSCT) was earlier than that of the second (P<0.05). There was no statistical difference between the first and the second AHSCT for the incidence of skin or mucous membrane bleeding (P>0.05). No patients occurred massive hemorrhage during SD-AHSCT. The quantity of platelet transfusion in the second AHSCT was larger than that in the first AHSCT (P<0.01). The incidence of oral ulcer in the first AHSCT was significantly higher than that in the second (P<0.01). No statistical difference between the first and the second AHSCT was there in infectious sites, infectious pathogens and infection incidence (P>0.10). All the complications were improved or cured, and no patients died of SD-AHSCT complications. In conclusion, SD-AHSCT is safe and feasible, and worthy to be further popularized.
出处
《中国实验血液学杂志》
CAS
CSCD
2005年第1期30-34,共5页
Journal of Experimental Hematology
关键词
造血干/祖细胞
自体外周血造血干细胞移植
骨髓移植
双次移植
并发症
autologous hemopoietic stem cell
autologous peripheral blood stem cell transplantation
bone marrow transplantation
double transplantation
complication
