论文部分内容阅读
目的 分析异基因干细胞移植后移植物抗宿主病 (GVHD)与预处理方式、干细胞来源和GVHD预防的关系及其对预后的影响。方法 对 5 6例异基因造血干细胞移植患者进行 2～ 2 5个月的临床随访。结果 (1)Ⅱ°～Ⅳ°急性GVHD的激素疗效明显不如Ⅰ°急性GVHD ,激素耐药的急性GVHD患者预后较差 (P <0 .0 5 ) ;(2 )非亲缘性骨髓移植患者的急、慢性GVHD发病率高于亲缘性骨髓移植 (R -BMT)患者 ,但均无显著差异 (P >0 .0 5 ) ;(3)非清髓性外周血干细胞移植 (NST)患者的急、慢性GVHD发病率与R -BMT患者相比无显著差异 (P >0 .0 5 ) ,但激素耐药的急性GVHD比例明显高于R -BMT患者 (P <0 .0 5 )。结论 GVHD是影响NST患者预后的主要因素 ,该类患者GVHD的预防和激素耐药的急性GVHD的治疗有待研究。
Objective To analyze the relationship between graft-versus-host disease (GVHD) and the pretreatment methods, the origin of stem cells and the prevention of GVHD after allogeneic stem cell transplantation and its effect on prognosis. Methods A total of 56 patients with allogeneic hematopoietic stem cell transplantation were followed up for 2 ~ 25 months. Results (1) The hormones of acute GVHD in Ⅱ ° ~ Ⅳ ° were significantly less effective than those in Ⅰ ° acute GVHD, and the prognosis of hormone-resistant acute GVHD was poor (P <0.05). (2) The non-related bone marrow transplantation patients The incidence of acute and chronic GVHD was higher than that of related bone marrow transplantation (R-BMT), but there was no significant difference (P> 0.05). (3) The urgency and severity of GVHD in non-myeloablative peripheral blood stem cell transplantation The incidence of chronic GVHD was not significantly different from that of R-BMT (P> 0.05), but the proportion of steroid-resistant acute GVHD was significantly higher than that of R-BMT (P <0.05). Conclusions GVHD is the main factor affecting the prognosis of patients with NST. The prevention of GVHD and the treatment of steroid-resistant acute GVHD in this group of patients are to be studied.