血液和骨髓干细胞移植在血液性恶性疾病中的异构血液和骨髓干细胞移植:一项随机试验
R Powles1, J Mehta, S Kulkarni
1Leukaemia Unit, Royal Marsden Hospital, and Institute of Cancer Research, Sutton, Surrey, UK. leukaemia@clara.net
Lancet (London, England)
|April 19, 2000
概括
外周血液干细胞 (PBSC) 提供更快的恢复和减少复发率,与骨髓在异构移植相比. 这项研究发现,PBSC移植导致更快的中性粒细胞和血小板恢复,以及更早的出院.
科学领域:
- 血液学 血液学 血液学
- 移植免疫学 移植免疫学
背景情况:
- 用外周血液干细胞 (PBSC) 自主移植显示出比骨髓更快的造血细胞重新填充.
- 这项研究前性地比较骨髓和PBSC用于异种移植.
研究的目的:
- 为了前性地比较使用骨髓与PBSC的异构移植的疗效和结果.
- 为了评估骨髓和PBSC全体移植之间的血液形成恢复,免疫复原和疾病复发的差异.
主要方法:
- 这是一项双盲随机研究,涉及39名患有恶性血液学疾病的成年患者.
- 患者接受了骨髓 (n=19) 或lenograstim动员的PBSC (n=20) 来自HLA相同的兄弟捐赠者在标准调节后.
- 产品的身份被掩盖了,直到移植后的一年.
主要成果:
- 与骨髓接受者相比,PBSC接受者表现出明显更快的中性粒细胞和血小板恢复.
- 接受PBSC的患者住院时间较短,疾病复发的可能性较低.
- 虽然移植与宿主疾病和整体存活率没有显著差异,但绝对淋巴细胞和CD25细胞等免疫恢复参数在4周后在PBSC组中更高.
结论:
- 对于来自HLA相同兄弟姐妹的全基移植,PBSC优于骨髓,提供更快的造血和免疫恢复.
- 使用PBSC有可能减少异构移植中疾病复发的可能性.
- 这些发现表明PBSC移植是特定患者群体的有利选择.
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