Antithymocyte Globulin / antilymphocyte Globulin Ntxiv rau raum-nourishing Suav tshuaj

Hu rau:joanna.jia@wecistanche.com/ WhatsApp: 008618081934791

Xudong Tang, et al

Abstract

Lub Hom Phiaj:

Txhawm rau tshawb xyuas cov txiaj ntsig ntawm anti-thymocyte globulin (ATG) / antilymphocyte globulin (ALG) ntxivraum-nourishingSuav tshuaj (KNCM) rau mob hnyav aplastic anemia (SAA).

Txoj kev:

Nees nkaum tsib yam kev mob hnyav aplastic anemia tau kho nrog ATG / ALD ntxiv rau KNCM thaum xyoo 1992 thiab 2009, thiab cov ntaub ntawv kho mob ua ntej thiab tom qab kev kho mob tau sau thiab tshuaj xyuas.

TSEEM CEEB:

Ntawm 25 tus neeg mob, 9 tus neeg mob yuav luag zoo, 6 tau txhim kho, 5 tau txais kev zam txim, thiab 5 tsis ua tiav. Tag nrho cov txiaj ntsig tau zoo yog 80.0 feem pua ​​. Lub xyoo 3- xyoo, 5- xyoo, 10- xyoo, 15- xyoo ciaj sia nyob tau raws li 98.6 feem pua, 97.3 feem pua ​​, 97.3 feem pua ​​, 67.5 feem pua ​​, thiab lub sij hawm muaj sia nyob nruab nrab yog 180 muaj. Piv nrog rau cov xwm txheej ua ntej muab cov tshuaj ATG/ALG ntxiv rau KNCM, tom qab 2 lub lis piam, cov reticulocyte thawj zaug tau txhim kho (P=0.001); ib hlis tom qab, ua raws li palette (P=0.037); ob lub hlis tom qab, los ntawm neutrophil cell nyob rau hauv peripheral ntshav (P=0.001); Peb lub hlis tom qab, tom qab ntawd los ntawm hemoglobin (P=0.012). Los ntawm kev ua 1- xyoo rov qab, 1 rooj plaub ntawm qhov teeb meem --paroxysmal nocturnal hemoglobinuria (PNH) tau txheeb xyuas, thiab tus neeg mob tseem muaj sia nyob niaj hnub no.

NYEEM NTXIV:ATG/ALG ntxiv rau KNCM tau muaj txiaj ntsig zoo rau SAA thiab tuaj yeem txhim kho cov neeg mob txoj sia nyob.

Ntsiab lus:Ntshav qab zib, aplastic; Txhim kho lub raum; Tshuaj, suav tshuaj ntsuab; antilymphocyte serum; anti-thymocyte serum

Nyem qhov no kom tau txais cov ntaub ntawv ntxiv txog covcov khoom cistanche zoo heev

Taw qhia

Severe aplastic anemia (SAA) yog ib yam mob uas yuav loj hlob zuj zus tuaj thiab muaj cov neeg tuag coob heev. Nws yog ib hom kab mob refractory ntawm cov kab mob hematological. Cov kev tshawb fawb pom tias feem ntau cov aplastic anemias yog tshwm sim los ntawm kev tiv thaiv kab mob.1 Qhov mob hnyav heev aplastic anemia (VSAA), qhov mob hnyav dua, yog tus cwj pwm los ntawm cov neeg tuag ntau dua thiab feem ntau nrog cov kab mob hnyav thiab cov hemorrhage. 20 xyoo dhau los, qhov kev tuag ntawm VSAA yog ze li ntawm 100 feem pua. Raws li VSAA qhov tshwm sim ntawm qhov mob tshwm sim, kev loj hlob sai, mob ntshav siab, kub taub hau, thiab mob hnyav heev, nws tau txhais thiab sib tham ua "Ji Lao", "Re Lao" lossis "Xue Zheng" hauv tshuaj suav tshuaj (TCM). Nyob rau hauv 2004, lubHematological Pawg neegntawm Suav Koom Haum Koom Tes ntawm Kev Sib Koom Tes ntawm Cov Tshuaj Kho Mob thiab Western tau txhais SAA li "Ji Sui Lao" raws li TCM txoj kev xav. Lub tuam tsev ntawm Xiyuan Tsev Kho Mob tau koom nrog kev tshawb fawb hauv AA thiab nws tau kho tus mob nrog kev koom ua ke ntawm TCM thiab Western Tshuaj txij li xyoo 1950s2-3 thiab tau thovraum-nourishingraws li lub hauv paus ntsiab lus tseem ceeb hauv AA txoj kev kho mob nrog TCM, uas tau lees paub tias yog ib txoj hauv kev zoo dua rau kev mob aplastic anemia. Pib los ntawm xyoo 1990, anti-thymocyte globulin (ATG) /antilymphocyteglobulin(ALG) ntxiv rau lub raum-nourishing Suav tshuaj (KNCM) tau siv los ua thawj kab kev kho mob rau SAA thiab VSAA. Txog hnub tim, ob peb tsab ntawv tshaj tawm tau tshaj tawm ntawm VSAA txoj kev kho mob nrog ATG/ALG ntxiv rau KNCM. Hauv daim ntawv no, peb tshaj tawm peb cov txiaj ntsig ntawm kev kho VSAA nrog kev koom ua ke ntawm TCM nrog Western Tshuaj los ntawm 1992 txog 2009.

Txoj kev

Cov kawm

Nees nkaum xya yam ntawm hom-I VSAA tau raug xaiv los ntawm Lub Tsev Haujlwm Saib Xyuas Hematology ntawm Xiyuan Tsev Kho Mob ntawm Suav Academy ntawm Suav Tshuaj Sciences. 2 ntawm lawv tau tso tseg tom qab ATG tau tswj hwm 2 lub hlis vim muaj teeb meem nyiaj txiag. 25 tus neeg kawm, 17 txiv neej thiab 8 tus poj niam tau raug kho thiab tshuaj xyuas. Lawv cov hnub nyoog muaj hnub nyoog li ntawm 7 txog 61 xyoo nrog lub hnub nyoog nruab nrab ntawm 29, thiab cov kab mob kis tau los ntawm 1 txog 6 lub hlis nrog qhov nruab nrab ntawm 1.1 lub hlis. 11 tus neeg raug kho nrog ATG (ntawm lawv, 5 nrog nees los tiv thaiv tib neeg cov tshuaj tiv thaiv; 6 nrog luav los tiv thaiv tib neeg) thiab 14 tus neeg tau kho nrog ALG.

Cov txheej txheem kuaj mob

VSAA tau kuaj pom nrog Camitta cov qauv (1925) rau SAA ntxiv rau cov suav neutrophil uas tsawg dua 0.2 × 109 /L.

Kev kho mob

Kev tswj hwm ntawm ATG/ALG: ALG (swine anti- human T cell immunoglobulin, Wuhan Institute of Biological Products, PR China), intravenously guttae (iv gtt) 20-30 mg/(kg·d). ATG (nees anti-human T cell immunoglobulin, Genzyme Polyclonals SAS), iv gtt 8.3-13.4 mg/(kg·d); ATG (luav tiv thaiv tib neeg T cell immunoglobulin, Genzyme Polyclonals SAS), iv gtt 2.5-3.2 mg/(kg·d), ATG (Lavbit anti-human T cell immunoglobulin, Fresenius Biotech GmbH), iv gtt 5- 7 mg/(kg·d). Tom qab qhov kev ntsuam xyuas tsis zoo ntawm cov ntsiab lus tau lees paub tias tsis zoo, ATG / ALG tau tswj hwm, iv gtt QD, rau lawv rau 5 hnub. Txhua zaus ua ntej kev tswj hwm ntawm ATG / ALG, 5 mg ntawm Dexamethasone tau muab tshuaj los ntawm venous infusion thiab 25 mg ntawm promethazine hydrochloride los ntawm kev txhaj tshuaj intramuscular. Kev tswj hwm ntawm KNCM: Raws li TCM txoj kev xav, lub raum tsis muaj peev xwm tuaj yeem faib ua rau lub raum-Yang deficiency thiab lub raum-Yin deficiency. Thaum lub raum tau txais kev noj qab haus huv, tus po tuaj yeem tau txais kev noj qab haus huv thiab cov ntshav ua haujlwm, cuam tshuam txog cov tshuaj lom neeg raug tshem tawm nyob ntawm qhov tshwm sim ntawm cov qauv sib txawv.

Cov tshuaj suav siv feem ntau yog raws li hauv qab no: Radix Rehmannia, Fructus Corni, Polugo num Multiflorum Thunb, Fructus Psoralea, Cuscuta Chinensis Lam, Radix morinda Officinalis, Songaria Cynomorium thiab Herba Epimedii. Qhov sib ntxiv ntawm cov tshuaj ntxiv yog nyob ntawm qhov tshwm sim ntawm kev sib txawv: rau tus qauv nrog raum tsis muaj peev xwm, Fructus Mori, Glossy privet txiv hmab txiv ntoo, Mayflower solomonseal rhizome, thiab Barbury wolfberry txiv hmab txiv ntoo tau ntxiv; rau cov qauv nrog manifest lub raum-Yang deficiency, Rhizoma curculiginis thiabHerba nrugtau ntxiv. Rau cov qauv nrog cov tsos mob ntawm tus po tsis txaus, Radix pseu Stellaria, Loj lub taub hau atractylodes rhizome, Common yam rhizome tau ntxiv; rau cov qauv nrog cov tsos mob ntawm cov ntshav tsis txaus, Astragalus membranaceus, Suav angelica, Suav peony, thiab Placenta hominins tau ntxiv. Rau cov qauv nrog cov ntshav stasis, Radix salvia miltiorrhiza, Millettia dielsiana, Leonurus heterophyllous, thiab Rhizoma linguistic chuanxiong tau ntxiv; rau cov qauv nrog rau cov tshuaj tua hluav taws kub, Smilax glabra, Taraxacum, Flos Lonicera, thiab Weeping forsythia txiv hmab txiv ntoo tau ntxiv. Cov tshuaj tau decoction thiab noj ob zaug ib hnub twg thaum sawv ntxov thiab yav tsaus ntuj. Cov chav kawm ntawm kev kho mob yog 6 lub hlis, thiab ob chav kawm sib law liag tau tswj hwm. Tom qab ua tiav ob chav kawm, txhua tus neeg mob uas pom tias muaj kev loj hlob yuav tsum tau kho nrog tib txoj kev kho mob tsawg kawg yog 1 xyoos lossis ntau dua.

Kev txhawb nqa thiab kev kho mob palliative: Txhua tus neeg mob uas tau txais kev kho mob saum toj no tau muab tshuaj rau qhov ncauj Cyclosporin A. Nws tau pib noj ntawm koob tshuaj 6 mg / (kg·d) BID, tom qab ntawd cov koob tshuaj tau hloov kho raws li cov tshuaj ntshav siab ( kom nws cov trough concentration ntawm 200-400 ng/mL). Kev kho mob yog 6 lub hlis lossis ntau dua. Tom qab lub hemogram ruaj khov, koob tshuaj tau maj mam txo, thiab thaum kawg, nws tau tso tseg; Stanozolol (6-12 mg/d) lossis testosterone undecanoate capsule ({5}} mg/d) tau noj BID qhov ncauj. Tom qab lub peripheral hemogram tau zoo li qub, koob tshuaj tau txo qis thiab khaws cia rau 3 xyoos. Cov granulocytes-colony stimulating factor tau muab coj los ntawm koob tshuaj ntawm 5 ug / (kg·d) kom txog thaum suav cov neutrophil granulocytes ntau dua 1 × 109 / L; Kev hloov ntshav tau ua thaum hemoglobin qis dua 60 g / L thiab suav cov platelets tsawg dua 10 × 109 / L lossis thaum muaj kev pheej hmoo ntau ntxiv ntawm cov ntshav, cov machine-collected pallet tau hloov pauv.

Kev tiv thaiv thiab kev kho mob tsis zoo: Thaum siv ATG/ALG, cov neeg mob tau thov kom nyob hauv pawg ntseeg nrog 100- qib huab cua huv kom tsis txhob kis kab mob. Lawv cov ntshav suav tau kuaj txhua hnub lossis txhua hnub thaum tsim nyog. Nyob ntawm qhov tshwm sim ntawm hemogram, cov pob txha pob txha yuav rov kuaj dua. Hypersensitiveness thiab serum kab mob tau saib xyuas thaum lub sij hawm tswj hwm ntawm ATG / ALG. Cov tsos mob tau saib yog hypertrichosis, digestive ib ntsuj av tsis zoo, tes tshee, periphery sensation txo, pyrexia, los ntshav, tawv nqaij khaus, kuv salvia, ureterocele. Kev kuaj mob siab thiab lub raum ua haujlwm tsis tu ncua, electrocardiogram thiab X-ray tau ua, hemocluture tau ua, thiab hauv siab CT ua yog tias tsim nyog.

Kev Tiv Thaiv thiab Kev Kho Mob Ntshav Qab Zib: Tom qab ATG / ALG kev kho mob, Prednisone acetate tau noj ntawm qhov ncauj ntawm koob tshuaj 50 mg / d. Yog tias cov tshuaj tiv thaiv mob ntshav qab zib tau tshwm sim, prednisone acetate tau hloov nrog methylprednisolone, uas tau muab rau ntawm koob tshuaj 40-200 mg / d, iv gtt tsis pub dhau ib lub lis piam, tom qab ntawd nws cov koob tshuaj maj mam txo. Thaum kis tau tshwm sim, siv tshuaj tua kab mob. Yog tias muaj kev ua haujlwm tsis zoo ntawm lub siab, Polyene Phosphatidylcholine thiab diammonium glycyrrhizinate tau muab raudaim siab kev tiv thaiv lub hom phiaj.

Kev soj ntsuam zoo

Cov txheej txheem kev ntsuas kev ua tau zoo tau tsim los ntawm cov qauv kev soj ntsuam uas tau tsim los ntawm Lub Rooj Sib Tham Plaub Lub Tebchaws ntawm Aplastic Anemia uas muaj nyob rau xyoo 1987,5 Qhov kev ua tau zoo tau muab qhab nia raws li kev kho, kev xa rov qab, kev txhim kho, thiab tsis ua haujlwm. Thiab thawj 3 qib, kev kho mob, kev xa rov qab, thiab kev txhim kho, raug suav hais tias muaj txiaj ntsig.

Cov ntaub ntawv tsom xam

SPSS 13.0 tau ua haujlwm rau kev txheeb xyuas cov ntaub ntawv. Matched-pair qauv t-test tau ua los sib piv txhais tau tias ua ntej thiab tom qab kev kho mob hauv tib pab pawg. Qhov sib txawv tau suav tias yog qhov tseem ceeb yog tias P-tus nqi tsawg dua lossis sib npaug rau 0.05.

TSEEM CEEB

Kev ua tau zoo ntawm ATG/ALG ntxiv rau KNCM hauv kev kho VSAA (Table 1)

Table 1 piav qhia cov ntaub ntawv ntawm 25 tus neeg mob VSAA tau kho nrog kev kho mob thiab ua raws li 1 xyoos lossis ntau dua tom qab lawv ua tiav qhov kev cuam tshuam.

Kev hloov ntawm hemograms ua ntej thiab tom qab kev kho mob ntawm ATG / ALG ntxiv rau KNCM (Table 2)

Los ntawm Table 1, peb tuaj yeem pom tias 2 lub hlis tom qab kev kho mob, cov neutrophil pib nce siab (P= 0.001); tias hemoglobin nce tshwm sim 3 lub hlis tom qab kho (P=0.012); uas reticulocytes pib nce sai sai 2 lub lis piam tom qab kev kho mob (P= 0.001); uas platelet nce ntau heev 1 hli tom qab kho (P=0.037).

Survival Curve rau kev kho mob ntawm ATG/ALG ntxiv rau KNCM (Daim duab 1)

Los ntawm daim duab 1, peb tuaj yeem pom tias, tom qab Kev Kho Mob ntawm ATG / ALG ntxiv rau KNCM, qhov ciaj sia taus rau 3 xyoos, 5 xyoos, 10 xyoo thiab 15 xyoo yog 98.6 feem pua, 97.3 feem pua, 97.3 feem pua, 67.5 feem pua.

Cov tshuaj tiv thaiv tsis zoo thiab qhov teeb meem mus ntev

Kev ua xua tshwm sim hauv 23 VSAA kis tom qab ATG / ALG tau tswj hwm. Ntawm tag nrho cov neeg mob ntawm cov tshuaj tiv thaiv mob ntshav qab zib; pyrexia tshwm sim hauv 22 tus neeg mob; daim tawv nqaij ua pob khaus hauv 21 tus neeg mob; arthrodynia hauv 19 tus neeg mob; thiab mob hauv siab hauv 1 tus neeg mob. Tom qab siv tshuaj methylprednisolone, prolamine, thiab calcium gluconate, tag nrho cov tsos mob tau zoo tuaj. Cov tshuaj tiv thaiv mob ntshav qab zib tau tshwm sim ntxov li thawj hnub tom qab ATG / ALG tau tswj hwm thiab qhov tseeb tshaj plaws tau tshwm sim rau hnub 30 tom qab ATG / ALG tau muab thiab cov tshuaj tiv thaiv tau ntev li ntawm 4-8h. Lub sij hawm ntawm kev soj ntsuam yog li ntawm 51 txog 172 lub hlis. Lub sijhawm nruab nrab ntawm kev soj ntsuam yog 104 lub hlis. Thaum lub sijhawm soj ntsuam, tus neeg mob 2 tau tshaj tawm tias tuag. Ib tug relapsed thiab tsim rau PNH, uas tseem muaj sia nyob niaj hnub no.

Kev sib tham

VSAA yog ib qho kev phom sij rau lub neej uas ua rau cov pob txha ua haujlwm tsis zoo. Cov mob no ua rau cov pob txha liab raug hloov los ntawm cov qe qe uas yog cov roj ntsha tshwj xeeb, thiab txo qis ntawm tag nrho cov qe ntshav. Feem ntau, etiology raug suav hais tias yog idiopathic, tab sis ib qho kev paub txog yog ib qho kev mob autoimmune uas T lymphocytes tua cov pob txha pob txha.6 Aplastic anemia yog qee zaum cuam tshuam nrog kev cuam tshuam rau co toxins xws li benzene, lossis nrog kev siv qee yam tshuaj. , suav nrog chloramphenicol thiab carbamazepine. Kev raug ionizing hluav taws xob los ntawm cov khoom siv hluav taws xob lossis cov khoom siv hluav taws xob tsim hluav taws xob kuj tseem cuam tshuam nrog kev txhim kho ntawm VSAA.

Muaj ob peb cov ntaub ntawv ntawm VSAA hauv cov ntaub ntawv qub. Txawm li cas los xij, Huangdi's Internal Classic muaj ntau yam kev piav qhia ntawm cov tsos mob xws li daj ntseg, los ntshav, thiab pyrexia. Hauv Han Dynasty, Zhongjing Zhang thawj zaug sau lo lus Xulao rau cov xwm txheej hauv Synopsis ntawm Golden Chamber. Nyob rau hauv cov nqe lus ntawm TCM txoj kev xav, VSAA yog ib qho kev mob mus sij hawm ntev uas tshwm sim los ntawm qhov tsis muaj peev xwm nyob thoob plaws hauv chav kawm, uas cuam tshuam nrog lub plawv, lub siab, lub ntsws, lub ntsws, thiabraum.Qi thiab ntshav tsis txaus tshwm sim thawj zaug, tom qab ntawdraumtsis muaj peev xwm, thiab essence depletion ua raws li. Txawm hais tias tus mob no cuam tshuam nrog lub plawv, lub siab, tus po, thiab lub raum, lub raum muaj kev sib raug zoo rau VSAA.Lub raumtsis muaj peev xwmyog qhov tseem ceeb ntawm qhov pib thiab kev loj hlob ntawm VSAA.

Tam sim no, hauv Suav teb, kev kho mob tseem ceeb rau VSAA yog hnyav heevimmunosuppressive Kev kho mob (IST) xws li ATG/ALG thiab CsA. Cov neeg tuag nyob rau theem pib poob rau 9.6 feem pua. Raws li qee cov ntaub ntawv thaum ntxov, qhov ua tau zoo ntawm kev kho SAA nrog nees ATG tsuas yog 40 feem pua ​​-50 feem pua ​​thiab nrog rau kev sib xyaw ntawm ATG thiab CsA yog 70 feem pua ​​​​hauv lub sijhawm kho ntawm 3 thiab 6 lub hlis. Qhov zoo ntawm kev sib xyaw ua ke ntawm cov tshuaj yog tias ATG thiab CsA tuaj yeem ua rau ntau qhov sib txawv ntawm cov tshuajtiv thaiv kab mob. Niaj hnub no, ATG / CsA tseem siv nyob rau hauv txoj kev kho mob tsis tu ncua rau VSAA. Ntau tus neeg mob tau kawm hauv ntau lub chaw ua pov thawj tias qhov txiaj ntsig zoo ntawm txoj kev kho mob yog 70 feem pua ​​7 nrog rau 5-xyoo muaj sia nyob txog li 80 feem pua ​​-90 feem pua ​​.8 Kev tshawb fawb txog kev kho mob ntawm VSAA nrograum nourishingraws li txoj kev tseem ceeb rau AA tau pib thaum xyoo 1960. Hais tias kev kho mob ntawm AA yuav tsum tsom mus rau lub raum yog thawj zaug tawm tswv yim los ntawm Hematological Committee ntawm Tuam Tshoj Association ntawm kev koom ua ke ntawm tsoos tshuaj thiab Western tshuaj nyob rau hauv lub National Conference on ntshav kab mob kho los ntawm kev koom ua ke ntawm Suav thiab Western tshuaj muaj nyob rau hauv 1986 nyob rau hauv Dalian, Tuam Tshoj. Nyob rau hauv cov nqe lus ntawm TCM qauv sib txawv rau kev kho mob, lub raum deficiency qauv rau AA tau muab faib ua peb:Yangtsis muaj peev xwm, Yin deficiency,Yang thiab Yin deficiency. Puas tau txij li thaum pib ntawm 1990s, kev sib xyaw ntawm KNCM thiab ATG / ALG rau kev kho VSAA yog thawj zaug siv hauv Xiyuan Tsev Kho Mob hauv Beijing, Suav. Hauv peb qhov kev paub txog kev kho mob 25 VSAA cov neeg mob, tag nrho cov txiaj ntsig tau zoo yog 80.0 feem pua. Cov ciaj sia taus rau 3 xyoos, 5 xyoos, 10 xyoo, thiab 15 xyoo yog 98.6 feem pua, 97.3 feem pua, 97.3 feem pua, 67.5 feem pua. Cov reticulocyte, platelet, neutrophil, thiab hemoglobin pib nce 2 lub lis piam, 1 lub hlis, 2 hlis, thiab 3 lub hlis tom qab kev kho mob feem. Cov txiaj ntsig tau qhia tias cov tshuaj noj raum tau ua lub luag haujlwm tseem ceeb hauv kev kho VSAA thiab cov neeg mob lub sijhawm muaj sia nyob.

Rau tib neeg lub cev, ATG / ALG yog ib hom heterogenous protein, nws yog tsuas yog tsim los ntawm IgG, uas underlies allergy thiab mob ntshav qab zib. Peb txoj kev tshawb fawb pom tias cov tsos mob tuaj yeem ploj mus tsis pub dhau {{0}}} hnub ntawm txhua tus neeg mob uas muaj kev fab tshuaj (23/25,92.0%), tshwj xeeb tshaj yog 2-8h tom qab ATG/ALG yog thawj zaug siv, los ntawm kev qeeb nqis ntawm iv-gtt ceev ntawm ATG/ALG lossis nres siv nws thiab noj tshuaj xws li dexamethasone. Mob ntshav qab zib yog ib hom kab mob ua xua uas tshwm sim los ntawm cov ntshav ncig ntawm cov khoom ua xua. Nws yuav tshwm sim 7-14 hnub tom qab ATG/ ALG tau muab.9 Cov tsos mob tseem ceeb yog pyrexia, tawm pob, mob nqaij, thiab mob caj dab. Prednisolone tuaj yeem coj cov tshuaj tiv thaiv mob ntshav qab zib kom tswj tau ntawm koob tshuaj 40-200 mg / d thiab qhov koob tshuaj loj dua tsis tshua siv. Tsis pom muaj sequela. Yog li ALG/ATG muaj kev nyab xeeb hauv kev kho mob.

Qhov tseem ceeb tshaj plaws uas cuam tshuam qhov kev tshwm sim ntawm cov neeg mob kho nrog ATG yog rov qab los. Hauv Tebchaws Europe, tus nqi tshaj tawm yog 30 feem pua ​​-40 feem pua. Thawj cov tsos mob yog cov ntshav liab dependence thiab palette transfusion dependence, thiab CsA dependence recurring.6 Lub sij hawm ntev (10 xyoo) relapse tus nqi yog 33 feem pua, nrog ib tug nruab nrab relapse lub sij hawm ntawm 570 hnub.10 Qee zaum, ob peb tus neeg mob VSAA, nyob rau hauv kev xa rov qab rau kaum xyoo tom qab IST txoj kev kho, tsim rau cov kab mob clonal xws li PNH, MDS, AML, thiab lwm yam qog. Qhov tshwm sim ntawm PNH yog 9 feem pua ​​11 thiab lub xyoo 10- qhov tshwm sim ntau tshaj yog 16 feem pua ​​.12 Lwm qhov kev tshawb fawb qhia tias qhov tshwm sim ntawm tus kab mob clonal yog 10 feem pua ​​-40 feem pua ​​.13-14

Hauv peb txoj kev tshawb fawb, 25 tus neeg mob VSAA tau ua raws li tsawg kawg yog 1-xyoo, tsis pom qhov rov tshwm sim dua. Tsuas yog 1 rooj plaub tsim los rau hauv PNH. Tej zaum, qhov mob rov qab tsawg dua yog vim lub sij hawm rov qab luv dua. Lub sij hawm rov qab ntev dua tseem yuav ua. Txawm li cas los xij, kev kho mob ntawm VSAA nrog ATG / ALG raum-nourishing ntxiv rau suav tshuaj pom tau tias muaj txiaj ntsig zoo. Tsis tas li ntawd, txog niaj hnub no, tsis tau pom cov neeg tuag. Kev tshawb fawb ntxiv yuav sim tshawb xyuas seb VSAA siv nws li cas rau cov teeb meem.

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REFERENCES
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