Nghiên cứu ứng dụng ghép tế bào gốc tạo máu đồng loại trong bệnh suy tủy xương mức độ nặng với điều kiện hóa Cyclophosphamid và Fludarabine

Purpose: Application method of peripheral blood stem cell transplation for severe aplastic anemia on the National Institue of Hematology and Bood Transfusion. Subjects and Methods: Between November 2010 to February 2013, 6 patients with severe aplastic anemia, ( 40 years old, HLA matched donors or = 5/6 aliens) underwent allogeneic HCT on the National Institue of Hematology and Bood Transfusion. Technical process: mobilization, collection and preservation of stem cells collected from peripheral blood donors. The transplant conditioning consisted of CY (120mg/kg), fludarabine (125mg/m2 ) without ATG.. C5A combined with methotrexate was used as GVHD prophylaxis. Monitoring and comprehensive care are in level 1. Definitions: Neutrophil engraftment was defined to have occurred on the first of 3 consecutive days during which the ANC was 0.5 G/L, and to have platelet engraftment occurred on the first 3 consecutive days with a PLT counts 20 G/L without transfusion support. Graft failure: ANC not achieve 0.5 G/L after post-transplant 30 days. Graft rejection: reduced blood cell counts after the initial engraftment. Results: Technical process: mobilization, collection and preservation of stem cells from peripheral blood donors was administered effectively and has reached a high dose: CD34+ was 7.17 - 14.92 x 10 exponent 6 per kg patient waight (average 10.0). Complications: aGVHD grade I and IV was seen in two patients (33.33 percent ) and cGVHD grade I was seen in one patient (16.67 percent ); graft rejection was seen in one patient (16.67 percent ). Engraftment was observed in all six patients, success was seen in 4 patients. Conclusion: Technical process: mobilization, collection and preservation of stem cells from peripheral blood donors was administered_effectively. the authors were able to set up the conditioning regimen consisted of CY and Fludarabin without ATG, which is suitable for Vietnam's current condition. Transplant results was encouraging with a high rate of engraftment of 100 percent . the authors achieved success in 4 patients (66.67 percent ) with long term survival and life quality improvement without blood transfusion. The incidence of aGVHD was seen in two patients (33.33 percent ) and cGVHD in grade I was seen in one patient (16.67 percent ) and there was one case of graft rejection (16.67 percent ).