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目的 :探讨自体外周血造血干细胞移植 (Autologousperipheralbloodstemcellstransplantation ,ABSCT)治疗系统性红斑狼疮 (SLE)的临床效果。方法 :选择 9例SLE患者 ,应用BaxterCS - 30 0 0plus连续血流式血细胞分离机进行自体外周血造血干细胞采集。预处理方案 :分次全淋巴照射 (TLI) 12 - 16Gy ,环磷酰胺 5 0mg/kg(- 3,- 2 ,- 1d) ,ATG 10mg/kg(+1,2d)。外周血干细胞动员 :环磷酰胺 2 0 0 0mg/m2 ,G -CSF 5ug/kg/d。结果 :造血干细胞采集量 :MNC 3.32× 10 9/Kg(2 .6 7- 4.2 8) ,患者造血功能重建迅速 ,免疫重建特征为CD4 ,CD19细胞减低 ,CD8,CD16+ 56细胞升高。随访 8例完全缓解 ,1例部分缓解 ,未发生移植相关的严重并发症。结论 :ABSCT治疗SLE近期临床疗效显著 ,远期疗效尚须进一步探讨。疗效机理可能与预处理后组织中免疫病理细胞的减少 ,免疫球蛋白降低 ,自身抗体量的下降有关。
Objective: To investigate the clinical effect of autologous peripheral blood stem cell transplantation (ABSCT) on systemic lupus erythematosus (SLE). Methods: Nine patients with SLE were selected and autologous peripheral blood stem cell collection was performed using Baxter CS - 30 0plus continuous flow cytometer. Pretreatment regimens: 12 - 16 Gy TLI, 50 mg / kg cyclophosphamide (- 3, - 2, - 1 d) and ATG 10 mg / kg (+ 1, 2 d). Mobilization of peripheral blood stem cells: cyclophosphamide 200mg / m2, G-CSF 5ug / kg / d. Results: The collection of hematopoietic stem cells was 3.32 × 10 9 / Kg (2.6-6.28). The hematopoietic function of the patients was rapidly reconstructed. The characteristics of immune reconstitution were decreased of CD4 and CD19 cells and increased of CD8 and CD16 + 56 cells. Eight cases were followed up completely and one case was partially relieved. No serious complications related to transplantation occurred. Conclusion: The short-term clinical efficacy of ABSCT in the treatment of SLE is significant, and the long-term efficacy needs to be further explored. The therapeutic mechanism may be related to the reduction of immunopathological cells, immunoglobulins and the decrease of autoantibodies in pretreatment tissues.