在严重的综合免疫缺陷中进行骨髓移植
Eyal Grunebaum1, Evelina Mazzolari, Fulvio Porta
1Division of Immunology/Allergy, Department of Paediatrics, Research Institute, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.
JAMA
|February 2, 2006
概括
对于严重的综合性免疫缺陷 (SCID),HLA匹配的无关捐赠者 (MUD) 骨髓移植 (BMT) 提供了比HLA不匹配的相关捐赠者 (MMRD) BMT更好的生存和免疫复原,当一个HLA相同的亲戚无法获得时.
科学领域:
- 免疫学 免疫学 免疫学
- 儿科血液学 儿科血液学
- 移植科学 移植科学
背景情况:
- 严重联合免疫缺陷 (SCID) 治疗依赖于骨髓移植 (BMT).
- 家庭相关的,HLA相同的捐赠者 (RID) 提供了最佳的结果.
- 与HLA不匹配的相关捐赠者 (MMRD) 和与HLA不匹配的非相关捐赠者 (MUD) 是另一种选择,但结果各不相同.
研究的目的:
- 为了比较生存和免疫复合结果.
- 评估SCID患者中BMT的不同类型的供体.
- 评估RID,MUD和MMRD BMT的疗效.
主要方法:
- 对94名患有SCID的婴儿进行回顾性分析,这些婴儿接受了BMT.
- 1990年至2004年间在加拿大和意大利儿科中心收集的数据.
- 结果的比较,包括生存,移植失败和免疫复合.
主要成果:
- 存活率:RID (92.3%),MUD (80.5%),MMRD (52.5%). 这几种疾病的生存率都很高.
- MUD BMT的生存率明显高于MMRD BMT.
- 与MMRD BMT相比,MUD BMT导致了优越的长期T细胞复制.
结论:
- 对于SCID患者,MUD BMT是MMRD BMT的可行的替代品,缺乏HLA相同的捐赠者.
- MUD BMT提供了改进的移植,免疫复合和生存.
- 这项研究支持MUD BMT在特定的SCID病例中作为MMRD BMT的首选选择.
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