系统性红斑狼疮新的治疗方法--自体造血干细胞移植

摘要

@@ Immunoablation followed by autologous haematopoietic stem cell transplant (HSCT) has been explored in patients with severe systemic lupus who are unresponsive to conventional therapies or suffer intolerable side-effects. HSCT is the most commonly applied for haematologic al diseases,allowing repopulation of the bone marrow with normal,healthy haematopoietic stem cells and peripheral blood after chemotherapeutic ablation of "malignant" clones. HSCT has been used for a variety of autoimmune diseases. The hypothesis that disease mediating lymphocytes in patients with SLE should be prone to such eradication resulted in the first HSCT being performed for SLE in 1997. Over the past few years a number of case reports and small series have been published. The most often-used protocol consisted of mobilization with high-dose cyclophosphamide and granulocyte colony stimulating factor followed by cyclophosphamide plus antithymocyte globulin ± methylprednisolone as condition.rn目前人们尝试通过自体造血干细胞移植(HSCT)的免疫去除,治疗那些对常规治疗效果欠佳或产生难以耐受副作用的重症系统性狼疮患者.HSCT一般主要应用于血液疾病的治疗,通过化疗清除恶性克隆后使骨髓中正常健康的造血干细胞和外周血液得以再生,现也用于许多自身免疫性疾病.淋巴细胞介导疾病发生的系统性红斑狼疮(SLE)患者有可能得到根治,基于这个假设,1997年完成了第一例HSCT治疗SLE,在过去的几年中,又有一些病例和小的系列研究的报道.目前最常用的治疗方案是用大剂量环磷酰胺和粒细胞集落刺激因子动员造血干细胞,再用环磷酰胺加抗胸腺细胞球蛋白±甲强龙作为预处理.