Educational Course of the Wei Foundation for Pediatric Research Brief Case Reports-Bone Marrow Transplantation in Taiwan
Resource
ACTA PAEDIATRICA SINICA v.36 n.1 pp.42-45
Journal
ACTA PAEDIATRICA SINICA
Journal Volume
v.36
Journal Issue
n.1
Pages
42-45
Date Issued
1995
Date
1995
Author(s)
LIN, KAI-HSIN
CHEN, YAO-CHANG
Abstract
台灣自民國72年11月至82年10月在五個骨髓移植中心共進行了308例異體骨髓及80例 自體骨髓移植，治療的對象大多爲白血病、再生不良性貧血、淋巴瘤和海洋性 貧血病人。非親屬間的骨髓移植也於83年開始，骨央損贈資料庫從82年8月開始建立 ，至83年6月已達40, 000名志願者。週邊幹細胞移植也從82年開始進行。骨髓移植的 結果及併發症發生率和西方各國報告相類似，唯一不同的是，海洋性貧血病人佔10% ，而無病存活率爲44%，治療失敗的原因主要是移植物被排斥。另一個問題與 外國不同，台灣人口B型肝炎病毒感染率相當高(>90%)，骨髓移植中肝功能異常與B型 肝炎病毒的相關性值得探討。病人或損髓者當中有一個爲B型肝炎表面抗原陽 性，約100例如此的異體骨髓移植當中，有兩位發生B型肝炎相關的肝衰竭（約佔2%） 。 In Taiwan, a country with 21 million people, 388 bone marrow transplants (BMTs), 308 allografts and 80 autografts, were performed in 5 BMT centers from November 1983 to October 1993. The commonest indications were leukemia, aplastic anemia, lymphoma and thalassemia. Campaigns promoting unrelated marrow donor registry were started in August 1993 and recruited approximately 40000 volunteers within 11 months. A peripheral stem cell program is just beginning. The overall results of BMT in Taiwan are comparable to other countries. The complications of BMT are similar to Western series, except that acute GVHD was rarer in one large series; this observation needs further studies and confirmation. A particular indication for allogeneic BMT in Taiwan is thalassemia, accounting for 10% of all patients. Disease-free survival after BMT for thalassemia is 44%; graft rejection is the major cause of treatment failure. Another important issue is the role of hepatitis B virus (HBV) in BMT, since the prevalence of HBV infection in Taiwan is very high (>90%). Abnormal liver function is currently the most common complication and might be related to HBV. Among nearly 100 allogeneic BMTs with HBV carriers as either donor or recipient, 2 patients (approximately 2%) died of HBV-related hepatic failure. Whether the HBV status of the donor and recipient is an important prognostic factor remains to be defined.
Type
journal article