Marrow transplantation for treatment of aplastic anemia. An analysis of factors associated with graft rejection.
Marrow transplantation for treatment of aplastic anemia. An analysis of factors associated with graft rejection.
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骨髓移植用于治疗再生障碍性贫血。
DOI：
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发表时间：
1977
影响因子：
158.5
通讯作者：
E. Thomas
中科院分区：
文献类型：
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作者：
R. Storb;R. Prentice;E. Thomas
73名严重再生障碍性贫血患者接受了来自正常的、人类白细胞抗原相合的同胞的骨髓移植治疗，其中68人活得足够长，足以证明植入。在21名患者中，GARFT被拒绝，其中19名患者死亡。这项分析采用二元Logistic回归模型，旨在确定预测骨髓移植排斥反应的因素。在进入分析的24个因素中，只有两个与移植排斥反应密切相关：混合白细胞培养中的阳性相对反应指数表明患者对供者的敏感度(P<0.01)；用于移植的骨髓细胞数量较少(每公斤<3×10(8)个细胞)(P<0.01)。这些发现表明，应对致敏患者使用更有效的免疫抑制调节方案，并应获得尽可能多的供体骨髓，或许还应补充来自外周血的干细胞。
Seventy-three consecutive patients with severe aplastic anemia were treated by marrow grafts from normal, HLA-identical siblings, and 68 lived long enough to demonstrate engraftment. In 21 patients the garft was rejected, and 19 of these patients died. This analysis, using a binary logistic regression model, was aimed at identifying factors that predicted marrow-graft rejection. Of the 24 factors entered into the analysis, only two strongly correlated with graft rejection: a positive relative response index in mixed leukocyte culture indicating sensitization of patient against donor (P less than 0.01); and a low number of marrow cells ( less than 3 X 10(8) cells per kilogram) used for transplantation (P less than 0.01). These findings suggest that more powerful immunosuppressive conditioning regimens should be used in patients who are sensitized, and that the greatest possible amount of donor marrow, perhaps supplemented by stem cells derived from the peripheral blood, should be obtained.