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目的 评价霉酚酸酯 (MMF)联合环孢菌素A(CsA)和短程甲氨蝶呤 (MTX)预防非亲缘异基因骨髓移植中急性移植物抗宿主病 (aGVHD)的有效性和安全性。方法 12例患者非亲缘异基因骨髓移植当天始联合应用MMF(骁悉胶囊 ) 1.0g/d ,CsA 3mg·kg-1·d-1,MTX移植后第 1天 15mg/次 ,移植后第 3,6 ,11天 10mg/次预防aGVHD。结果 12例非亲缘异基因骨髓移植患者中 ,1例于移植后第 7天发生Ⅳ度超急性GVHD ,2例分别于移植后第 10天和第 17天发生Ⅱ度aGVHD ,经甲泼尼龙和MMF治愈 ,其余患者未发生aGVHD。治疗中与MMF相关不良反应为白细胞减少 ,调整剂量后血常规得以恢复 ,不影响移植患者的造血重建。结论 在非亲缘异基因骨髓移植中应用MMF联合CsA、MTX预防aGVHD是有效的。
Objective To evaluate the efficacy and safety of mycophenolate mofetil (MMF) combined with cyclosporin A (CsA) and short-course methotrexate (MTX) in the prevention of acute graft-versus-host disease (aGVHD) in unrelated allogeneic bone marrow transplantation . Methods 12 cases of non-allogeneic bone marrow transplantation combined with MMF 1.0g / d, CsA 3mg · kg-1 · d-1 on the day of MTX transplantation, 15mg / , 6, 11 days 10mg / times prevent aGVHD. Results Of the 12 unrelated allogeneic bone marrow transplant recipients, one had grade Ⅳ hyperacute GVHD on the 7th day after transplantation, and two had grade Ⅱ aGVHD on the 10th and 17th day after transplantation. After transplanted with methylprednisolone and MMF was cured, and the remaining patients did not develop aGVHD. Adverse reactions associated with MMF were leukopenia during treatment, and the blood routine was restored after the dose was adjusted without affecting the hematopoietic reconstitution in the transplant patients. Conclusion The combination of MMF and CsA in non-related allogeneic bone marrow transplantation is effective in preventing aGVHD.