親緣間異基因造血干細胞移植后急性移植物抗宿主病的發(fā)病特點、預防與治療的臨床分析.pdf

1、新疆醫(yī)科大學碩士學位論文親緣間異基因造血干細胞移植后急性移植物抗宿主病的發(fā)病特點、預防與治療的臨床分析姓名：田猛申請學位級別：碩士專業(yè)：內科學（血液?。┲笇Ы處煟航?01004新疆醫(yī)科大學醫(yī)學碩士學位論文2Theclinicalanalysisofacteristictherapyofacutegraftversushostdiseaseafterrelatedallogenichematopoieticstemcelltranspl

2、antationPostgraduate：TianMengSupervis:JiangMingAbstractObjective:Toreptoccurrenceacteristicsofacutegraftversushostdiseaseafterallogeneicperipheralbloodstemcelltransplantationevaluatetheefficacyofmethylprednisolonecyclosp

3、ineAincombinationwithotherdrugtreatmentprogramsindifferentgradelocationofacutegraftversushostdisease.Methods:Analysisthecomplicationsof140patientswithalloPBSCTinclude78HLAsiblingmatchedpatients62HLAsiblinghaploidmatchedp

4、atients.UsingCsAMMFMTXglucocticoidtopreventGVHDfHLAsiblingmatchedpatientsaddantithymocyteglobulin(ATG)CD25monoclonalantibodythedoseusingtimeofMMFglucocticoidfHLAsiblinghaploidmatchedpatients.AcuteGVHD(aGVHD)werediagnosed

5、accdingtotheinternationalcommonlyacceptedGVHDdiagnosticcriteriaComparingoccurrenceofaGVHDontimepositionintwogroup.MethylprednisoloneCsAwereusedasfirstlinetherapyCD25monoclonalantibodywasusedassecondlinesalvagetherapy.Res

6、ults:Undertheconditionofpositiveprophylaxis35.0%patientswerediagnosedaswithaGVHDgradeⅢ～ⅣaGVHDdevelopedin7.14%patients.21.8%patientsdevelopedaGVHDinsiblingmatchedgroupcomparedwith51.6%patientsinsiblinghaploidmatchedgroup.

7、83.93%patientsshowedresponsetoMethylprednisoloneCsAtherapyinclude62.5%completeresponse21.43%partialresponse.Responsesoccurredwithskindiseaseliverdiseasegastrointestinaldiseaseshownodifferences.GradeⅠ～ⅡaGVHDshowbetterresp

8、onsethanGradeⅢ～Ⅳ.Methan50%patientsshowedresponsetoCD25monoclonalantibodywhoresistanttoMethylprednisoloneCsA.Conclusion:PositiveprophylaxisdecreasetheoccurrenceofaGVHD.MepatientsdevelopedgradeⅠ～ⅡaGVHDinsiblinghaploidmatch