低剂量ATG联合低剂量PTCY预防单倍型相合移植患者移植物抗宿主病的回顾性分析

雷金美; 刘林; 袁忠涛; 李玉; 罗乐; 李小平; 黎诗琦; 王三斌

doi:10.16016/j.2097-0927.202310048

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低剂量ATG联合低剂量PTCY预防单倍型相合移植患者移植物抗宿主病的回顾性分析

专题报道：血液肿瘤诊治前沿 | 更新时间：2026-01-09

- 低剂量ATG联合低剂量PTCY预防单倍型相合移植患者移植物抗宿主病的回顾性分析
- Low-dose ATG combined with low-dose PTCY in preventing GVHD after haploidentical transplantation: a retrospective analysis of 90 cases
- 陆军军医大学学报 2024年46卷第4期页码：326-330
- 作者机构：
  
  1.650100 昆明，中国人民解放军联勤保障部队第九二〇医院血液科
  2.671000 大理，大理大学研究生院
- 作者简介：
  
  [王三斌，E-mail: Sanbin1011@163.comWANG Sanbin, E-mail: Sanbin1011@163.com
- 基金信息：
  
  云南省重大科技专项-生物医药专项(202102AA100011)
- DOI：10.16016/j.2097-0927.202310048
  中图分类号： R181.32;R392.8;R552.05
- 收稿：2023-10-13，
  
  修回：2023-12-22，
  
  纸质出版：2024-02-28
- 稿件说明：
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雷金美, 刘林, 袁忠涛, 等. 低剂量ATG联合低剂量PTCY预防单倍型相合移植患者移植物抗宿主病的回顾性分析[J]. 陆军军医大学学报, 2024,46(4):326-330.

Jinmei LEI, Lin LIU, Zhongtao YUAN, et al. Low-dose ATG combined with low-dose PTCY in preventing GVHD after haploidentical transplantation: a retrospective analysis of 90 cases[J]. Journal of Army Medical University, 2024, 46(4): 326-330.
雷金美, 刘林, 袁忠涛, 等. 低剂量ATG联合低剂量PTCY预防单倍型相合移植患者移植物抗宿主病的回顾性分析[J]. 陆军军医大学学报, 2024,46(4):326-330. DOI： 10.16016/j.2097-0927.202310048.

Jinmei LEI, Lin LIU, Zhongtao YUAN, et al. Low-dose ATG combined with low-dose PTCY in preventing GVHD after haploidentical transplantation: a retrospective analysis of 90 cases[J]. Journal of Army Medical University, 2024, 46(4): 326-330. DOI： 10.16016/j.2097-0927.202310048.

摘要

目的

回顾性分析低剂量抗胸腺细胞球蛋白(antithymocyte globulin

ATG)联合低剂量移植后环磷酰胺(post transplantation cyclophosphamide

PTCY)预防单倍型相合移植患者移植物抗宿主病(graft versus host disease

GVHD)的疗效及安全性。

方法

收集2022年1月至2023年2月在中国人民解放军联勤保障部队第九二〇医院血液科行单倍型相合移植的90例患者资料

按照研究对象接受不同的GVHD预防方案分为研究组和对照组

研究组为低剂量ATG联合低剂量PTCY组

总共47例; 对照组为标准剂量PTCY组

总共43例。对两组患者的植入情况、GVHD的发生情况、生存情况等指标进行分析。

结果

① 两组患者均成功植入

研究组中性粒细胞植入的中位时间显著短于对照组(11

17 d

0.05)、血小板植入的中位时间显著短于对照组(12

20 d

0.05)。研究组Ⅱ~Ⅳ度aGVHD发生率显著低于对照组(12.8%

34.9%

0.05)、Ⅲ~Ⅳ度aGVHD发生率显著低于对照组(6.4%

20.9%

0.05)、非复发死亡率显著低于对照组(6.4%

20.9%

0.05)、出血性膀胱炎的发生率显著低于对照组(12.8%

34.9%

0.05)。②截至研究结束

两组轻度cGVHD的发生率、中重度cGVHD的发生率、复发率、EB病毒及巨细胞病毒再激活率、总生存率、无进展生存率差异均无统计学意义。

结论

对于单倍型相合移植而言

低剂量ATG联合低剂量PTCY方案具有较低的GVHD发生率、非复发死亡率、出血性膀胱炎发生率及植入较快的优势。

Abstract

Objective

To retrospectively analyze the efficacy and safety of low-dose antithymocyte globulin (ATG) combined with low-dose post transplantation cyclophosphamide (PTCY) in prevention of graft versus host disease (GVHD) after haploidentical transplantation.

Methods

Clinical data of 90 patients receiving haplotype matched transplantation in No.920 H

ospital of PLA Joint Logistic Support Force from January 2022 to February 2023 were collected

and they were divided into study group (

=47) and control group (

=43) according to different GVHD prevention programs.The patients of the study group were given low-dose ATG combined with low-dose PTCY

and those of the control group received standard dose of PTCY.The implantation status

occurrence of GVHD

survival status and other indicators were analyzed between the 2 groups.

Results

① Both groups of patients were successfully implanted

the median duration for neutrophil implantation (11

17 d

0.05) and platelet implantation (12

20 d

0.05) was significantly shorter in the study group than the control group.The incidence of grade Ⅱ~Ⅳ aGVHD (12.8%

34.9%

0.05) and grade Ⅲ~Ⅳ aGVHD (6.4%

20.9%

0.05) was significantly lower in the study group than the control group

so was the non-recurrent mortality rate (6.4%

20.9%

0.05) and the incidence of hemorrhagic cystitis (12.8%

34.9%

0.05).② By the end of the study

there were no significant differences in the incidence of mild and moderate and severe cGVHD

recurrence rate

reactivation rates of EBV and CMV

overall survival rate or progression-free survival rate between the 2 groups.

Conclusion

For haploidentical transplantation

low-dose ATG combined with low-dose PTCY has the advantages of lower incidence of GVHD

non-recurrent mortality

incidence of hemorrhagic cystitis and faster implantation.

关键词

Keywords

references

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