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目前用抗入胸腺细胞球蛋白(ATG)和类似制剂,在预防和治疗实验动物或人的 GVHD,一般来说,如在移植前或移植后短期给予 ATG,或在输入前将移植的骨髓与 ATG 共同孵育,都可能有效果,但是 ATG 对干细胞可能有毒效,如接近移植时使用,可使移植失败。据报导用抗胸腺细胞血清治疗 GVHD能延长骨髓移植接受者的平均存活期。1976年起作者试用马 ATG 预防接受 HLA 相同的同胞兄妹骨髓移植接受者。病例选择:自1976年6月至1978年1月收入 FredHutchinson 癌症研究中心进行 HLA 相同的同胞兄妹骨髓移植的造血系统恶性肿瘤共78例。其中急粒25例,急淋36例,慢粒急变6例,其它急性白血病4例,原淋巴细胞性淋巴瘤白血病7例。方法:(1)骨髓移植前68例患者使用环磷酰胺(120mg/kg)和全身放射1,000拉德,其中22例还用过二甲基马利兰(5mg/kg),用联合化疗和全身照射者9例,仅用联合化疗者1例。(2)移植后,所有病人均接受免疫抑制治疗。第1天 MTX 15mg/m~2,第3,6,11天 MTX 10mg/m~2,以后每周一次至移植后102天止。(3)移植后7～28天内每天查血象和每周作骨穿一次。(4)骨髓移植后可利用的61例随机
Currently in the prevention and treatment of experimental animals or human GVHD with anti-thymocyte globulin (ATG) and similar agents, ATG, for example, is given shortly before or after transplantation or with bone marrow before transplantation ATG co-incubation may be effective, but ATG may be toxic to stem cells, such as close to the time of transplantation, transplantation can fail. Treatment of GVHD with anti-thymocyte serum has been reported to prolong the mean survival of recipients of bone marrow transplantation. In 1976, authors tested horse ATG prophylaxis against HLA-identical sibling bone marrow transplant recipients. CASE SELECTION: A total of 78 patients with hematopoietic malignancies undergoing HLA identical sibling bone marrow transplantation were enrolled in the Fred Hutchinson Cancer Research Center from June 1976 to January 1978. Of which 25 cases of acute particles, acute leaching 36 cases, 6 cases of acute blast crisis, 4 cases of other acute leukemia, lymphoblastic leukemia in 7 cases. Methods: (1) Cyclophosphamide (120 mg / kg) and total radionuclide irradiation of 1,000 rads were used in 68 patients before bone marrow transplantation. Twenty-two of the patients also received dimethylmallylene (5 mg / kg) 9 cases, only a combination of chemotherapy in 1 case. (2) After transplantation, all patients received immunosuppressive therapy. Day 1 MTX 15mg / m ~ 2, MTX 10mg / m ~ 2 on the 3rd, 6th and 11th days. (3) Check the blood and bone every week for 7 ~ 28 days after transplantation. (4) 61 cases of bone marrow transplantation available after random