自体外周血干细胞移植治疗难治性免疫性血小板减少性紫癜

基础医学与临床 ›› 2007, Vol. 27 ›› Issue (5): 573-576.

自体外周血干细胞移植治疗难治性免疫性血小板减少性紫癜

张薇周道斌赵岩冷晓梅蒋颖

山东大学齐鲁医院心内科济南协和医院协和医院北京协和医院风湿免疫科北京协和医院风湿免疫科

收稿日期:2006-10-17 修回日期:1900-01-01 出版日期:2007-05-25 发布日期:2007-05-25
通讯作者: 张薇

Outcome of refractory Autoimmune thrombocytopenia purpura treated with autologous peripheral blood stem cell transplantation

Received:2006-10-17 Revised:1900-01-01 Online:2007-05-25 Published:2007-05-25

摘要/Abstract

摘要： 目的探讨自体外周血干细胞移植（APBSCT）治疗难治性免疫性血小板减少性紫癜（ITP）的疗效及移植后免疫重建。方法对一例难治ITP患者进行APBSCT并观察临床疗效和免疫重建的过程。结果经环磷酰胺（CY）+G-CSF动员，获得CD34+细胞4.7′106/kg。在TBI+CY预处理后，中性粒细胞、血小板分别在第11、12天植入，无严重并发症。移植后6个月开始淋巴细胞各亚群逐渐恢复，CD4+/CD8+比例仍倒置，记忆T细胞（CD4+CD45RO+）的恢复先于纯真T细胞(CD4+CD45RA+)。随访至31个月时血小板始终大于100′109/L，疾病处于完全缓解中。结论 APBSCT可能是治疗难治性ITP的有效手段。

Abstract: Objective To explore the efficacy and immune reconstitution of autologous peripheral blood stem cell transplantation (APBSCT) in the treatment of refractory autoimmune thrombocytopenia purpura (ITP). Methods One patient with refractory ITP was treated with APBSCT， and the effectiveness and period of immune reconstitution were analyzed retrospectively. Results The case was mobilized by cyclophosphamide (CY) plus G-CSF and 4.7′106/kg CD34+ cell was gained totally. Neutrophil and platelet were engrafted at 11th and 12th day without severe complications following the conditioning of TBI and CY,. Although the each phenotype of the peripheral blood lymphocytes were recovered gradually 6 months after the transplant,inverted CD4/CD8 ratio exited and memory T cell was improved much earlier than na?ve T cell. The platelete count was constantly over 100′109/L and the patient was in complete remission after a follow-up of 31 months. Conclusion APBSCT maybe a effective means for refractory ITP.

张薇周道斌赵岩冷晓梅蒋颖. 自体外周血干细胞移植治疗难治性免疫性血小板减少性紫癜[J]. 基础医学与临床, 2007, 27(5): 573-576.

. Outcome of refractory Autoimmune thrombocytopenia purpura treated with autologous peripheral blood stem cell transplantation[J]. Basic & Clinical Medicine, 2007, 27(5): 573-576.