非清髓性异基因骨髓联合外周血造血干细胞移植治疗重型再生障碍性贫血的临床研究-血液内科专业论文.docxVIP

非清髓性异基因骨髓联合外周血造血干细胞移植治疗重型再生障碍性贫血临床研究 非清髓性异基因骨髓联合外周血造血干细胞移植治疗重型再生障碍性贫血临床研究 - PAGE 4 - PAGE 4 - A clinical analysis of non-myeloablative allogeneic bone marrow Combined with peripheral blood hematopoietic stem cell transplantation for severe aplastic anemia Postgraduate: Ghen gui-ping Supervisor:Prof. Wang shun-qing Department of Hematology, Guangzhou First Municipal People ’s Hospital Affiliated to Guangzhou Medical College Abstract Aplastic anemia is a disorder of bone marrow failure cuased by many factors,which is characterized by pancytopenia and the low proliferation.of bone marrow.The diagnosis of SAA need meet the following standard: The proliferation degree of bone marrow 25% of normal or 50% with normal hematopoietic cells 30%,and 2 or 3 of the following peripheral blood cell parameters:①neutrophil counts 0.5 ×10^9/L; ② absolute reticulocytes counts 40 ×10^9/L or transfusion dependence; ③platelet counts 20 ×10^9/L.Neutrophils counts 0.2 ×10^9/L is very severe aplastic anemia.Recent experimental results show that T cell-mediated immune attack hematopoietic stem cells (HSC) is the pathological basis of AA,the effec of immunosuppressive therapy (immunosupressive therapy, IST) precisely support this theory.SAA has poor clinical prognosis and high mortality with the natural course of 6 months or so.Allogeneic bone marrow transplantation and immunosuppressive therapy are Currently available treatments of SAA. As we know immunosuppressive therapy has high recurrence rate,bone marrow transplantation can cure SAA.However,the major hurdles that needs to be overcome in the allo-genetic transplantation setting are graft rejection,chronic graft-versus-host disease (a / cGVHD),conditioning regimen-related complications and higher mortality rates of bone marrow suppression.With conditioning regimen having been improved,such as irradiation T cyclophosphamide(CTX) and anti-lymphocyte globulin(ALG),the engraftment increased in ten years recently.But