查詢結果分析
相關文獻
- Allogeneic Bone Marrow Transplantation for Fourteen Patients with Severe Aplastic Anemia
- 再生不良性貧血必須骨髓移植嗎
- 談再生不良性貧血患者的護理
- 再生不良性貧血之骨髓移植
- Bone marrow transplantation for severe aplastic anemia in Children:Conditioning with cyclophosphamide and total lymphoid irraditation
- Treatment of Severe Aplastic Anemia:Comparison of Bone Marrow Transplantation to Immunotherapy
- 再生不良性貧血患者之骨髓移植
- 口腔病理與口腔診斷病例報告
- 再生不良性貧血
- Transplantation for Adrenoleukodystrophy with HLA-A and B Nonidentical Paternal Marrow: Report of One Case
頁籤選單縮合
題名 | Allogeneic Bone Marrow Transplantation for Fourteen Patients with Severe Aplastic Anemia=異體骨髓移植於十四例嚴重型再生不良性盆血之病人 |
---|---|
作者 | 薛爾榮; 黃偉修; 黃旭輝; 趙祖怡; 張俊彥; 王成俊; | 書刊名 | 中華醫學雜誌 |
卷期 | 57:4 1996.04[民85.04] |
頁次 | 頁247-253 |
分類號 | 415.513 |
關鍵詞 | 再生不良性貧血; 骨髓移植; 移植體對抗宿主疾病; 全身性放射治療; Aplastic anemia; Bone marrow transplantation; Cyclophosphamide; Graftversus-host-disease; Total body irradiation; |
語文 | 英文(English) |
中文摘要 | 背景:對於年紀較輕的嚴重型再生不良性貧血病患,骨髓移植是可治癒的最佳方法之一。而阻礙異體骨髓移植成功之因素包括移植體對抗宿主疾病、移植體被排斥及治療引起之毒性。我們報告了十四例嚴重型再生不良性貧血病人接受骨髓移植治療的經驗。 方法:自1986年12月至1995年5月,共14例嚴重型再生不良性貧血病人接受骨髓移植治療,其中13例異體移植,1例為同卵雙胞胎間移植。9位男性、5位女性;平均年齡24.7歲(15至3)。發病至接受移植之平均期間為93天(7至420);有5例為移植前未曾輸過血。移植前所用的調理治療為cyclophosphamide每公斤體重200毫克分4天靜注,之後在移植當天骨髓輸入前加照全身放射治療300cGy;2例末輸過血、1例輸過血及1例同卵雙胞胎間移植病患則只以cyclophosphamide做為移植前之調理。移植13例病患接受環靈素及短期methotrexate作為移植體對抗宿主疾病之預防。 結果:十四個病人中共11例病患仍存活及保持骨髓功能正常;存活時間為10至90個月,中值為39個月。而死亡的3例中,1例死於原發性移植體被排斥合併顱內出血,2例則為延遲性移植體被排斥合併敗血症。另一例同卵雙胞胎間移植病患在第一次移植6個月被排斥後,再度以同一捐髓者之骨髓移植成功。有5例發生急性移植體對抗宿主疾病,其中只有一例為臨床上中度以上者;而在可10例評估之病患中有2例慢性移植體對抗宿主疾病。 結論:從我們的研究可看出嚴重型再生不良性貧血病患進行骨髓移植前之調理組合cyclophosphamide及全身性放射治療為一有效且耐受性良好之方法;而急性移植體對抗宿主疾病之發生率相當低,因此對於40歲以下之嚴重型再生不良性貧血病病患俱有組織抗原配合之捐髓者,特別是未曾輸過血者,骨髓移植是可優先選擇之治療方法。 |
英文摘要 | Background: Bone marrow transplantation (BMT) is the best curative approach for younger patients with severe aplastic anemia (SAA). Major obstacles to success of allogeneic BMT include graft-versus-host disease (GVHD), graft rejection and treatment related toxicities. Experience with 14 SAA patients who received BMT is reported here. Methods: From December 1986 to May 1995, 14 patients with SAA were treated with BMT; 13 were allogeneic, and 1 was syngeneic. There were nine males and five females whose average age was 24.7 years (range 15-36 years). The median pretransplant disease duration was 93 days (range 7-610 days). Five patients were nontransfused before BMT. The pre-transplant conditioning regimen consisted of 200 mg/kg cyclophosphamide (CY) intravenously, divided over four consecutive days, followed by 300 cGy total-body irradiation (TBI) on the day before BMT. Two untransfused, one transfused patient and one syngeneic transplant received CY only as preconditioning. For GVHD prophylaxis, the 13 patients were given a combination of cyclosporine and a short course of methotrexate. Results: Of the 14 patients, 11 were still alive 10 to 90 months later, with functional engraftment; the median survival of 39 months. There were three deaths including one with primary graft failure with intracranial hemorrhage, and two with delayed graft rejection and sepsis. The patient who received syngeneic BMT developed late graft failure six months post-transplant, but was successfully treated with a second BMT. Acute GVHD occurred among 5 of the 13 engrafted patients, only one of whom was Grade III clinically. Chronic GVHD was observed in 2 out of 10 evaluable patients. Conclusions: The combination of CY and TBI is an effective, well-tolerated conditioning regimen for BMT in patients with SAA. The acute GVHD rate was low in our patients receiving cyclosporine. BMT is the treatment-of-choice for patients under the age of 40 with SAA, for those with human leucocyte antigen (HLA)-identical siblings or an identical twin and particularly for those patients who have not received transfusion. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。