{"id":3683,"date":"2020-03-23T16:12:39","date_gmt":"2020-03-23T09:12:39","guid":{"rendered":"http:\/\/new.vientebaogoc.edu.vn\/?post_type=blog_post&#038;p=1177"},"modified":"2024-11-24T07:58:41","modified_gmt":"2024-11-24T00:58:41","slug":"cay-ghep-te-bao-goc-trung-mo-dong-loai-de-dieu-tri-benh-thieu-mau-khong-tai-tao-mot-nghien-cuu-phase-ii-da-trung-tam","status":"publish","type":"post","link":"https:\/\/sci.edu.vn\/home\/blog\/2020\/03\/23\/cay-ghep-te-bao-goc-trung-mo-dong-loai-de-dieu-tri-benh-thieu-mau-khong-tai-tao-mot-nghien-cuu-phase-ii-da-trung-tam\/","title":{"rendered":"C\u1ea5y gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 \u0111\u1ed3ng lo\u00e0i \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh thi\u1ebfu m\u00e1u kh\u00f4ng t\u00e1i t\u1ea1o: m\u1ed9t nghi\u00ean c\u1ee9u phase II \u0111a trung t\u00e2m"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong><em><strong>Thi\u1ebfu m\u00e1u kh\u00f4ng t\u00e1i t\u1ea1o (Aplastic anemia &#8211; AA) l\u00e0 ch\u1ee9ng suy t\u1ee7y x\u01b0\u01a1ng \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi ch\u1ee9ng gi\u1ea3m t\u1ee7y v\u00e0 c\u1ea1n ki\u1ec7t c\u00e1c t\u1ebf b\u00e0o ti\u1ec1n th\u00e2n t\u1ea1o m\u00e1u. Qu\u00e1 tr\u00ecnh ph\u00e1 h\u1ee7y c\u00e1c t\u1ebf b\u00e0o ti\u1ec1n th\u00e2n t\u1ea1o m\u00e1u qua trung gian mi\u1ec5n d\u1ecbch \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh b\u1eb1ng c\u00e1c nghi\u00ean c\u1ee9u trong ph\u00f2ng th\u00ed nghi\u1ec7m v\u00e0 li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb mi\u1ec5n d\u1ecbch (IST). IST \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn nh\u01b0 l\u00e0 ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7u ti\u00ean cho AA. Tuy nhi\u00ean, 30% &#8211; 40% b\u1ec7nh nh\u00e2n thi\u1ebfu m\u00e1u thi\u1ebfu m\u00e1u tr\u1ea7m tr\u1ecdng (Severve AA &#8211; SAA) v\u1eabn ti\u1ebfp t\u1ee5c b\u1ecb b\u1ec7nh sau \u0111i\u1ec1u tr\u1ecb IST. Kho\u1ea3ng 20% \u200b\u200bb\u1ec7nh nh\u00e2n thi\u1ebfu m\u00e1u kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n tr\u1ea7m tr\u1ecdng (NSAA) ph\u1ee5 thu\u1ed9c v\u00e0o truy\u1ec1n m\u00e1u v\u00e0 cu\u1ed1i c\u00f9ng bi\u1ebfn th\u00e0nh SAA.<\/strong><\/em><\/strong><\/p>\n\n\n\n<figure class=\"wp-block-image\"><img decoding=\"async\" src=\"https:\/\/vientebaogoc.edu.vn\/wp-content\/uploads\/2019\/03\/Screen-Shot-2019-03-23-at-2.15.42-PM-1024x385.png\" alt=\"\" class=\"wp-image-8898\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">B\u1ec7nh nh\u00e2n c\u00f3 SAA th\u01b0\u1eddng kh\u00e1ng IST ho\u1eb7c nh\u1eefng ng\u01b0\u1eddi c\u00f3 t\u00e1i ph\u00e1t sau khi IST c\u00f3 th\u1ec3 tr\u1ea3i qua c\u1ea5y gh\u00e9p t\u1ebf b\u00e0o g\u1ed1c t\u1ea1o m\u00e1u \u0111\u1ed3ng lo\u1ea1i (HSCT). Tuy nhi\u00ean, kho\u1ea3ng m\u1ed9t ph\u1ea7n ba b\u1ec7nh nh\u00e2n kh\u00f4ng t\u00ecm th\u1ea5y m\u1eabu t\u1ebf b\u00e0o g\u1ed1c t\u1ea1o m\u00e1u ph\u00f9 h\u1ee3p cho HSCT. B\u1ec7nh nh\u00e2n&gt; 50 tu\u1ed5i kh\u00f4ng \u0111\u1ee7 \u0111i\u1ec1u ki\u1ec7n \u0111\u1ec3 c\u1ea5y gh\u00e9p. Sau khi theo d\u00f5i HSCT, c\u00f3 th\u1ec3 x\u1ea3y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 b\u1ec7nh m\u1ea3nh gh\u00e9p ch\u1ed1ng k\u00ed ch\u1ee7 (GVHD). T\u1ef7 l\u1ec7 s\u1ed1ng sau 5 n\u0103m (OS) c\u1ee7a b\u1ec7nh nh\u00e2n v\u1edbi AA l\u00e0 \u0111\u00e1p \u1ee9ng v\u1edbi IST &lt;60%.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ebf b\u00e0o g\u1ed1c trung m\u00f4 c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb t\u1ee7y x\u01b0\u01a1ng (BM-MSCs), nh\u01b0 c\u00e1c th\u00e0nh ph\u1ea7n t\u1ebf b\u00e0o n\u1ec1n quan tr\u1ecdng c\u1ee7a t\u1ee7y x\u01b0\u01a1ng, c\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 qu\u00e1 tr\u00ecnh t\u1ea1o m\u00e1u v\u00e0 l\u00e0 c\u00e1c t\u1ebf b\u00e0o g\u1ed1c \u0111a n\u0103ng m\u00e0 c\u00f3 th\u1ec3 bi\u1ec7t ho\u00e1 th\u00e0nh nhi\u1ec1u lo\u1ea1i t\u1ebf b\u00e0o kh\u00e1c nhau.<br \/><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">BM-MSC bi\u1ec3u hi\u1ec7n MHC -I th\u1ea5p nh\u01b0ng kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n c\u1ee7a c\u00e1c ph\u00e2n t\u1eed tr\u00ean b\u1ec1 m\u1eb7t MHC-II; do \u0111\u00f3, truy\u1ec1n t\u0129nh m\u1ea1ch BM-MSC c\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh v\u00ec t\u1ebf b\u00e0o c\u00f3 th\u1ec3 l\u1ea9n tr\u1ed1n mi\u1ec5n d\u1ecbch. MSC c\u0169ng bi\u1ec3u hi\u1ec7n c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf protease \u0111\u1ec3 n\u00e9 tr\u00e1nh ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3. BM-MSCs c\u00f3 t\u00e1c d\u1ee5ng \u0111i\u1ec1u h\u00f2a mi\u1ec5n d\u1ecbch \u0111\u1ed1i v\u1edbi t\u1ebf b\u00e0o lympho \u0111\u00e3 ho\u1ea1t h\u00f3a, bao g\u1ed3m t\u1ebf b\u00e0o T, t\u1ebf b\u00e0o B, t\u1ebf b\u00e0o gi\u1ebft t\u1ef1 nhi\u00ean, v\u00e0 c\u00e1c t\u1ebf b\u00e0o tua.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tr\u00ean c\u01a1 s\u1edf d\u1eef li\u1ec7u tr\u01b0\u1edbc \u0111\u00e2y, c\u00e1c t\u00e1c gi\u1ea3 \u0111\u00e3 ti\u1ebfn h\u00e0nh nghi\u00ean c\u1ee9u nhi\u1ec1u pha kh\u00f4ng \u0111\u1ed1i ch\u1ee9ng v\u00e0 \u0111a trung t\u00e2m \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 v\u00e0 s\u1ef1 an to\u00e0n c\u1ee7a BM-MSC \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n AA.<br \/><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">74 b\u1ec7nh nh\u00e2n t\u1eeb 7 trung t\u00e2m \u0111\u00e3 nh\u1eadn BM-MSC v\u1edbi li\u1ec1u 1-2&nbsp; tri\u1ec7u t\u1ebf b\u00e0o\/kg m\u1ed7i tu\u1ea7n trong 4 tu\u1ea7n. C\u00e1c ph\u1ea3n \u1ee9ng \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 \u1edf m\u1ee9c 0,5, 1, 2, 3, 6, 9, v\u00e0 12 th\u00e1ng sau khi truy\u1ec1n t\u1ebf b\u00e0o \u0111\u1ea7u ti\u00ean. B\u1ec7nh nh\u00e2n \u0111\u00e1p \u1ee9ng \u1edf 1 th\u00e1ng ti\u1ebfp t\u1ee5c nh\u1eadn \u0111\u01b0\u1ee3c 4 l\u1ea7n truy\u1ec1n.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u1ef7 l\u1ec7 \u0111\u00e1p \u1ee9ng t\u1ed5ng th\u1ec3 l\u00e0 28,4% (kho\u1ea3ng tin c\u1eady 95%, 19% -40%), \u0111\u00e1p \u1ee9ng ho\u00e0n to\u00e0n 6,8% v\u00e0 \u0111\u00e1p \u1ee9ng m\u1ed9t ph\u1ea7n l\u00e0 21,6%. Sau th\u1eddi gian theo d\u00f5i trung b\u00ecnh 17 th\u00e1ng, t\u1ef7 l\u1ec7 s\u1ed1ng s\u00f3t chung l\u00e0 87,8%. B\u1ea3y b\u1ec7nh nh\u00e2n b\u1ecb nh\u1ee9c \u0111\u1ea7u nh\u1eb9 v\u00e0 s\u1ed1t nh\u1eb9, nh\u01b0ng kh\u00f4ng th\u1ea5y c\u00f3 c\u00e1c ph\u1ea3n \u1ee9ng ph\u1ee5 kh\u00e1c.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">K\u1ebft qu\u1ea3 n\u00e0y cho th\u1ea5y r\u1eb1ng gh\u00e9p MSC \u0111\u1ed3ng lo\u00e0i l\u00e0 ph\u01b0\u01a1ng ph\u00e1p m\u1edbi an to\u00e0n, hi\u1ec7u qu\u1ea3 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n AA kh\u00f4ng \u0111\u00e1p \u1ee9ng li\u1ec7u ph\u00e1p mi\u1ec5n d\u1ecbch.<\/p>\n\n\n\n<p class=\"has-text-align-right wp-block-paragraph\"><strong><em>(Ph\u1ea1m V\u0169)<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Tham kh\u1ea3o:<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"http:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/sctm.16-0227\/abstract\">http:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/sctm.16-0227\/abstract<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Thi\u1ebfu m\u00e1u kh\u00f4ng t\u00e1i t\u1ea1o (Aplastic anemia &#8211; AA) l\u00e0 ch\u1ee9ng suy t\u1ee7y x\u01b0\u01a1ng \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi ch\u1ee9ng gi\u1ea3m t\u1ee7y v\u00e0 c\u1ea1n ki\u1ec7t c\u00e1c t\u1ebf b\u00e0o ti\u1ec1n th\u00e2n t\u1ea1o m\u00e1u. Qu\u00e1 tr\u00ecnh ph\u00e1 h\u1ee7y c\u00e1c t\u1ebf b\u00e0o ti\u1ec1n th\u00e2n t\u1ea1o m\u00e1u qua trung gian mi\u1ec5n d\u1ecbch \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh b\u1eb1ng c\u00e1c nghi\u00ean c\u1ee9u [&hellip;]<\/p>\n","protected":false},"author":293,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"advanced_seo_description":"","jetpack_seo_html_title":"","jetpack_seo_noindex":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[161],"tags":[],"class_list":["post-3683","post","type-post","status-publish","format-standard","hentry","category-ban-tin"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/posts\/3683","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/users\/293"}],"replies":[{"embeddable":true,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/comments?post=3683"}],"version-history":[{"count":1,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/posts\/3683\/revisions"}],"predecessor-version":[{"id":4472,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/posts\/3683\/revisions\/4472"}],"wp:attachment":[{"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/media?parent=3683"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/categories?post=3683"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/sci.edu.vn\/home\/wp-json\/wp\/v2\/tags?post=3683"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}