Objective: To evaluate the clinical effect of haploid allogeneic hematopoietic stem cell transplantation(haplo-HSCT) in the treatment of severe aplastic anemia (SAA), and to explore the efficacy different between post-transplant cyclophosphamide (PT/Cy) and standard-dose ATG.
Methods: The clinical data of 38 patients with SAA in our hospital from January 2012 to December 2019 were collected and retrospectively analyzed. The efficacy was evaluated. The patients with haplo-HSCT were divided into low-dose ATG combined with PT/Cy group and standard-dose ATG group, and the blood cell hematopoietic reconstruction time, GVHD incidence, mortality and survival time of the patients in the two groups was compared.
Results: Among the 32 patients, hematopoietic reconstitution were detected in 9375%(30/32) recipients. The median time of neutrophil and platelet engraftment was 15(10-22) days and 13(7-30) days, respectively. The incidence of GVHD was 21.89%, the incidence of infection was 93.75%, and the 2-year overall survival rate was 84.38%. The hematopoietic reconstitution time, incidence of GVHD, mortality rate and survival time were no statistical differences between the patients in the two groups(all P>0.05).
Conclusion: Haplo-HSCT is an effective method for the treatment of SAA,low-dose ATG combined with PT/Cy can lighten the economic burden on patients, it would be a feasible treatment plan for SAA with light side effect.
题目: 单倍型异基因造血干细胞移植联合后置环磷酰胺(PT/Cy)治疗重型再生障碍性贫血患者的临床研究.
目的: 评估单倍型异基因造血干细胞移植(haplo-HSCT)治疗重型再生障碍性贫血(SAA)患者的疗效;探讨联合后置环磷酰胺(PT/Cy)与标准剂量ATG方案预防GVHD疗效的区别.
方法: 收集并回顾性分析2012年1月至2019年12月于我院接受haplo-HSCT的SAA患者32例的临床资料,评价治疗疗效。将接受haplo-HSCT治疗的患者按预防移植物抗宿主病(GVHD)方案不同,分为低剂量ATG联合PT/Cy方案和标准剂量ATG组,比较两组患者血细胞造血重建时间、GVHD发生率、死亡率及生存时间的差异.
结果: 32例患者中,30例获得造血重建,重建率93.75%,中性粒细胞、血小板中位植入时间分别为15(10-22)d、13(7-30)d。GVHD发生率为21.89%,感染发生率为93.75%,2年总生存率为84.38%。低剂量ATG联合PT/Cy组和标准剂量ATG组患者造血重建时间、GVHD发生率、死亡率、生存时间差异均无统计学意义(P>0.05).
结论: Haplo-HSCT是治疗SAA的有效方法,低剂量ATG联合PT/Cy方案可减轻患者的经济负担,副作用小,是治疗SAA可行的方案.
Keywords: efficacy; haploid allogeneic hematopoietic stem cell transplantation; severe aplastic anemia.