[异体造血干细胞移植治疗再生障碍性贫血]。

Yasushi Onishi
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引用次数: 0

摘要

在使用抗胸腺细胞球蛋白和环孢素A的免疫抑制疗法(IST)中加入血小板生成素受体激动剂艾曲波帕(eltrombopag)后,再生障碍性贫血患者对初始疗法的反应有所改善,但仍有约三分之一的患者因耐药或复发而需要进行异基因造血干细胞移植(HSCT)。异基因造血干细胞移植作为初始疗法适用于年龄小于 40 岁的患者(尤其是在以下情况下
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[Allogeneic hematopoietic stem cell transplantation for aplastic anemia].

The addition of the thrombopoietin receptor agonist eltrombopag to immunosuppressive therapy (IST) with horse antithymocyte globulin and cyclosporin A has improved response to initial therapy for aplastic anemia, but about one-third of patients still require allogeneic hematopoietic stem cell transplantation (HSCT) due to resistance or relapse. Allogeneic HSCT as initial therapy is indicated when the patient is younger than 40 years of age (especially <20 years) and has an HLA-matched sibling donor. On the other hand, fulminant aplastic anemia, in which the neutrophil count is 0 even with G-CSF administration, requires transplantation regardless of donor type. When an HLA-matched donor is not available and an early transplant is needed, cord blood transplantation and haploidentical transplantation are options. In the past few years, haploidentical transplantation with post-transplantation cyclophosphamide (PTCY) as GVHD prophylaxis has been shown to produce favorable outcomes in patients with aplastic anemia. A retrospective study in Japan also showed a good engraftment rate after haploidentical transplantation with PTCY. This review discusses transplant indications for aplastic anemia and selection of donor type and conditioning regimen.

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