| 王继军,胡凯,赵伟,景红梅,克晓燕.造血干细胞移植中预先全身照射对全身及造血系统的影响及并发症治疗[J].中华放射医学与防护杂志,2010,30(5):523-526 |
| 造血干细胞移植中预先全身照射对全身及造血系统的影响及并发症治疗 |
| Effects of total body irradiation combined with high-dose chemotherapy on hematopoietic stem cell transplantation |
| 投稿时间：2010-04-13 |
| DOI： |
| 中文关键词: 全身照射 造血干细胞移植 急性放射病 |
| 英文关键词:Whole body irradiation Hematopoietic stem cell transplantation Acute radiation syndrome |
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| 中文摘要: |
| 目的 探讨全身照射联合高剂量化疗对造血干细胞移植患者全身和造血系统影响的特点和治疗,为急性放射病的诊治提供临床经验。方法 回顾分析64例接受造血干细胞移植患者,系统观察急性照射及大剂量化疗后患者血液学改变及临床不良反应,并分析其骨髓重建特点。结果 移植相关病死率3.12%。移植后随访9～72个月 (中位随访时间26个月)。1、3、5年生存率分别为(95.8±3.3)%, (89.8±4.7)%和(81.7±6.9)%。全身照射联合高剂量化疗后,所有患者均出现了血液学不良反应,以白细胞及血小板下降最为明显,白细胞总数最低值为(0.18±0.13) ×109个/L,血小板最低值为(14.48±8.85)×109个/L;在造血干细胞支持及粒细胞集落刺激因子(G-CSF)应用后,均可恢复。此外患者不同程度出现消化道反应、感染、肝功能受损及出血等不良反应,经相关治疗后好转。结论以TBI联合高剂量化疗为预处理,随后进行造血干细胞移植,患者恶性血液系统疾病治疗效果好,并且其临床情况在一定程度上模拟了急性放射病的临床过程,为急性放射病的救治提供了一定的临床经验。 |
| 英文摘要: |
| Objective To explore the effects of total body irradiation (TBI) combined with high-dose chemotherapy as conditioning regimen on the whole body and hematopoietic system of patients undergoing hematopoietic stem cell transplantation, and to sum up the clinical experiences in diagnosis and treatment of acute radiation syndrome. Methods Atotal of 64 patients underwent TBI and high-dose chemotherapy and then received hematopoietic stem cell transplantation. The hematologic changes and clinical toxicity after TBI were observed and the characteristics of bone marrow reconstitution analyzed. Results The transplantation related mortality was 3.12%. Follow-up was carried out post transplantation for 9-72 months (the median follow-up time was 26 months). 1, 3, 5-year overall survival rates were (95.8 ± 3.3)%, (89.8 ± 4.7)% and (81.7 ± 6.9)%, respectively. All patients suffered from hematologic toxicity. The white blood cells and platelets were obviously decreased. The minimum total number of white blood cells was (0.18 ± 0.13) ×109/L, and the minimum platelet was (14.48 ± 8.85) ×109/ L. In addition, gastrointestinal reactions, infection, liver damage, bleeding and other adverse reactions occurred to some extent. Conclusions TBI combined with high-dose chemotherapy as conditioning regimen followed by hematopoietic stem cell transplantation might be effective for treatment of malignant hematological diseases. The clinic conditions after TBI and high-dose chemotherapy could simulate the clinical course of acute accidental radiation syndrome and provide the clinical experience for acute radiation syndrome. |
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