论文部分内容阅读
目的交流伴多种高危因素的非血缘异基因外周血干细胞移植(URD-PBSCT)经验。方法对伴有高龄、孕产史多、乙型肝炎、陈旧性肺结核、移植物抗宿主病、肺部真菌病等移植高危因素的急性淋巴细胞白血病患者行URD-PBSCT的过程进行总结分析。结果患者造血重建迅速,ANC>0.5×109/L,PLT>20×109/L的时间分别为+15d、+20d;+67d患者的血型由AB型转变为供者的B型;移植+38d出现Ⅰ度急性移植物抗宿主病,予甲强龙治疗后控制;+131d肺部真菌感染,经伏立康唑针治疗后好转;移植过程中肺部结核未复发,乙肝DNA拷贝持续<103。结论对具有高危因素的URD-PBSCT患者,移植相关并发症的防治致关重要。
Objective To investigate the experience of URD-PBSCT with multiple high-risk factors in the treatment of non-hereditary allogeneic peripheral blood stem cell transplantation. Methods The clinical data of URD-PBSCT in patients with acute lymphoblastic leukemia associated with advanced age, multiple pregnancy history, hepatitis B, old pulmonary tuberculosis, graft versus host disease and pulmonary mycosis were summarized. Results The hematopoietic reconstitution was rapid in patients with ANC> 0.5 × 109 / L and PLT> 20 × 109 / L for + 15d and + 20d, respectively. The blood type of patients with + 67d was changed from AB to donor B; A degree of acute graft-versus-host disease was observed and controlled after treatment with methylprednisolone; + 131d pulmonary fungal infection was improved after treatment with voriconazole; pulmonary tuberculosis did not recur during transplantation, and DNA copy of hepatitis B persisted <103. Conclusion The prevention and treatment of transplant-related complications is important for URD-PBSCT patients with high risk factors.