[鲁索利替尼预防儿童地中海贫血非亲属或单倍体同种造血干细胞移植后移植物抗宿主病的临床观察]。

Ya-Mei Chen, Xiu-Li Hong, Jin-Zong Lin, Jie Shi, Quan-Yi Lu
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引用次数: 0

摘要

目的:回顾性分析鲁索利替尼治疗非亲属或单倍体干细胞移植后儿童地中海贫血的疗效和安全性。方法:2020年3月至2021年3月,22例同种异体造血干细胞移植成功患者在厦门大学中山医院接受鲁索利替尼治疗(2.5 mg,每日2次),观察所有不良反应,包括aGVHD、cGVHD、CMV和EBV感染。结果:22例患者行同种异体干细胞移植,5例诊断为aGVHD, 3例为I-II级皮肤GVHD, 2例为II级肠道GVHD,均治愈。所有患者均随访21周以上,4例发生cGVHD,其中3例为局限性肝脏GVHD, 1例为肺部GVHD,经积极治疗后均缓解。8例患者EBV拷贝数升高(>3×103/ml), 3例患者CMV拷贝数升高,经免疫抑制剂和抗病毒治疗后均恢复。无巨细胞病毒感染和EBV相关移植后淋巴细胞增生性疾病(PTLD),无移植相关死亡。结论:Ruxolitinib可在不影响造血恢复的情况下,有效降低GVHD的发生率和严重程度,改善地中海贫血患儿移植后的生存状况。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[The Clinical Observation with Ruxolitinib as Graft-Versus-Host Disease Prophylaxis for Children with Thalassemia after Unrelated or Haploidentical Allo-Hematopoietic Stem Cell Transplantation].

Objective: To retrospectively analyze the efficacy and safety of ruxolitinib therapy for children with thalassemia after unrelated or haploidentical stem cell transplantation.

Methods: From March 2020 to March 2021, 22 patients received successfully allogeneic hematopoietic stem cell transplantation in the Zhongshan Hospital of Xiamen University, from +30 to 100 days,those patients received ruxolitinib therapy (2.5 mg, twice daily) and all adverse reactions were observed, include aGVHD, cGVHD, CMV and EBV infection.

Results: 22 patients underwent allogeneic stem cell transplantation, 5 patients were diagnosed as aGVHD, 3 patients had grade I-II skin GVHD and 2 patients had grade II intestinal GVHD, those patients were cured. All patients were followed up for more than 21 weeks, 4 cases developed cGVHD, including 3 cases of localized liver GVHD and 1 case of pulmonary GVHD, those were relieved after active treatment. 8 patients had elevated EBV copies (>3×103/ml), and 3 patients had increased CMV copies, the patients recovered after immunosuppressant and antiviral treatment. There was no CMV infection and EBV related post-transplantant lymphoproliferative disorders(PTLD), and no transplant related deaths.

Conclusion: Ruxolitinib can effectively reduce the incidence and severity of GVHD without affecting the hematopoietic recovery, and improve the survival status of thalassemia children after transplantation.

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