Clinical report of two patients diagnosed as intestinal form and extremely severe bone marrow form of acute radiation sickness treated with allogeneic peripheral stem cell transplantation
- VernacularTitle:异基因外周血造血干细胞移植治疗极重度骨髓型和肠型急性放射病的临床报告
- Author:
Huisheng AI
;
Changlin YU
;
Jianhui QIAO
- Publication Type:Journal Article
- Keywords:
hematopoietic stem cell transplantation;
transplantation conditioning;
radiation injuries
- From:
Medical Journal of Chinese People's Liberation Army
1981;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical significance of allogeneic peripheral stem cell transplantation in the treatment of acute radiation sickness.Methods Two victims were accidentally irradiated by a 60Co source in a nuclear accident in Jining,Shandong province,China in 2004.They were exposed to more than 20-25 Gy(patient A)and 9-15Gy(patient B)of 60Co-ray,and were diagnosed as having developed intestinal form of acute radiation sickness(ARS)and extremely severe bone marrow form of ARS,respectively.After the treatment with the preparative regimens based on low-doses of fludarabine,antilymphocyte globulin and cyclophosphamide,the two patients successfully received HLA-haploidentical(patient A)and HLA-identical(patient B)peripheral blood stem cell transplantation(PBSCT),respectively,7 days after the exposure.Cyclosporin A combined with mycophenolate mofetil was used for the prevention of graft-versus-host disease(GVHD).In addition,bone marrow mesenchymal stem cells from a donor were administered into patient A by intra-bone marrow injection.Results Both peripheral blood and bone marrow examinations showed the recovery of hemopoiesis after PBSCT,and neither patients displayed obvious clinical signs of GVHD.However,patient A died of septicemia and multi-organ failure on day 33 after the exposure,while patient B died of heart failure dominant multi-organ failure on day 75 after the exposure.Conclusions Allogeneic PBSCT is a feasible and effective treatment for ARS,while infection and multi-organ failure are major causes of death of the patients.
