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目的 :研究自体造血干细胞移植治疗血液系统恶性肿瘤过程中环孢素A(CSA)能否诱导移植物抗宿主病(GVHD) ,并确定其毒副反应。方法 :进行自体造血干细胞移植的 10例血液系统恶性肿瘤患者接受CSA静脉滴注1.5mg/ (kg·d) ,0～ 2 8d ,观察皮疹情况、有无腹泻及血清胆红素水平来判断GVHD的发生 ;同时观察移植后造血重建、感染、出血以及检测肝、肾功能来分析其治疗的毒副反应。结果 :2例次早期出现GVHD ,皮疹为 +和 + + ,出现时间分别为移植后 8和 17d ,持续时间较短 ( 4和 5d) ,外周血WBC计数分别为 0 .9× 10 9/L和 0 .2× 10 9/L ;6例次患者出现GVHD皮疹 ( 1例 + ,5例 + + ,不包括前述 2例次 )的时间为 30d( 2 2～ 4 4d) ,皮疹持续时间为 18d( 9～ 2 8d) ,外周血WBC计数为 1.4 5× 10 9/L[( 0 .4～ 2 .6 )× 10 9/L]。对移植后造血重建、感染、出血 ,以及肝、肾功能的影响不明显。结论 :CSA在自体造血干细胞移植过程中可以安全地诱导GVHD的发生 ,但其抗肿瘤效应的证据有待于进一步研究
Objective: To investigate whether CSA can induce graft-versus-host disease (GVHD) in the treatment of hematologic malignancies and to determine the toxicity of autologous hematopoietic stem cell transplantation. Methods: Ten patients with malignant hematological malignancies undergoing autologous hematopoietic stem cell transplantation received 1.5 mg / (kg · d) CSA intravenously for 0 ~ 28 days. The patients were followed up for rash, diarrhea and serum bilirubin levels to determine GVHD The incidence of hematopoietic reconstitution, infection, hemorrhage and the detection of liver and kidney function after transplantation were analyzed to analyze the toxic and side effects of the treatment. Results: The incidence of GVHD was early in 2 cases, the rash was + and + +, the appearance time was 8 and 17 days after transplantation, the duration was short (4 and 5 days), and WBC counts in peripheral blood were 0.9 × 10 9 / L And 0 .2 × 10 9 / L respectively. The time of rash of GVHD (1 case +, 5 cases + + excluding the above two cases) was 30 days (ranged from 2 to 44 days) in 6 cases. The rash duration was 18d (9 ~ 28d), peripheral blood WBC count was 1.4 5 × 10 9 / L [(0.4 ~ 2.6) × 10 9 / L]. Hematopoietic reconstruction after transplantation, infection, bleeding, and liver, kidney function is not obvious. CONCLUSIONS: CSA can safely induce GVHD during autologous hematopoietic stem cell transplantation, but the evidence for its anti-tumor effect remains to be further studied