HLA全相合异基因造血干细胞移植与免疫抑制剂治疗重型再生障碍性贫血的比较

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背景:国外有报道显示异基因造血干细胞移植和免疫抑制疗法治疗急性重型再生障碍性贫血的有效率及总生存期相当,但两种疗法治疗后的生活质量及治疗费用方面的差异报道较少。目的:回顾性分析同胞HLA全相合异基因造血干细胞移植与免疫抑制疗法治疗急性重型再生障碍性贫血的疗效。方法:入选2004-07/2010-10在南京鼓楼医院血液科行同胞HLA全相合异基因造血干细胞移植的7例及行免疫抑制疗法的16例急性重型再生障碍性贫血患者,每3个月定期进行随访。结果与结论:异基因造血干细胞移植组在粒细胞和血小板恢复时间,脱离输血时间,治疗后3个月总有效率及治疗后12个月完全缓解率均优于免疫抑制疗法组,但治疗后12个月总有效率差异无显著性意义。异基因造血干细胞移植组与免疫抑制疗法组的总生存率分别为86%与81.3%,两组比较差异无显著性意义。治疗1年后两组患者总体健康状况及功能健康状况均提示良好,两组住院费用差异无显著性意义。 Background: It has been reported in foreign countries that allogeneic hematopoietic stem cell transplantation and immunosuppressive therapy are effective in treating acute severe aplastic anemia. However, the difference in quality of life and cost of treatment after the two therapies has been reported. OBJECTIVE: To retrospectively analyze the therapeutic effect of HLA allogeneic allogeneic hematopoietic stem cell transplantation and immunosuppressive therapy on acute severe aplastic anemia. Methods: Selected from July 2004 to October 2010, 7 patients with HLA allogeneic allogeneic hematopoietic stem cell transplantation in the blood bank of Nanjing Drum Tower Hospital and 16 patients with acute severe aplastic anemia who underwent immunosuppressive therapy were randomized every 3 months Follow-up. RESULTS AND CONCLUSION: In allogeneic hematopoietic stem cell transplantation group, the recovery time of granulocyte and platelet, the time of blood transfusion, the total effective rate at 3 months after treatment and the complete remission rate at 12 months after treatment were better than that of immunosuppressive therapy group. However, after treatment There was no significant difference in total effective rate at 12 months. The overall survival rates of allogeneic hematopoietic stem cell transplantation group and immunosuppressive therapy group were 86% and 81.3% respectively, with no significant difference between the two groups. After 1 year of treatment, the general health status and functional health status of both groups were all good, and there was no significant difference between the two groups in hospitalization costs.
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