The Observation And Follow-up Visit About Autologous Peripheral Blood Stem Cell Treatment For Myasthenia Gravis(MG)

To explore the clinical effect and safty of treatment of Refractory Myasthenia Gravis by autologous peripheral blood stem cell transplantationin, four MG patients were chosen to deal with the method.Methods:autologous peripheral blood stem cells (APBSCs) were mobilized with cyclophosphamide (CTX) and granulocytecolony-stimulating factor (G-CSF).The CD34+cells harvesting was performed by continuous flow leukapheresis using a CS-3000plus blood separator, then APBSCs were collected and preserved at4℃in refrigerator.then the patients were conditioned by CTX (60mg/kg/d, for2days)+maphalan(120mg/m2/d, for1day)+thymus radiotherapy+plasma exchange. To clear away T cell, antilymphocyteglobulin was used (10mg/kg/d, for2days)after APBSCs had been reinfused.Granulocyte recovery was stimulated by G-CSF. The four patients' clinical manifestations and immunologic markers were compared before and after transplantation.Results:1,The first MG patients got an excellent clinical remission after transplantation in2～8months,and The patients' clinical manifestations and immunologic markers were completely remission after about two years. But she took the disease again two years latter. Then she had to take back hormone and anticholinesterase drugs to keep her physical strength.2.the second MG patient were completely remission after five months. there was no relapse by nine years observed results.3.The third patient got an excellent clinical remission after transplantation in about2months, too. Then completely remission afte about3years. There was no relapse by8years observed results.4.The forth MG patient felt batter after the transplantation in about5months,and he can do some housework as normal.lyear and2months latter, he got an excellent clinical remission,too. Conclussions:APBSCT is effective and safe for MG, and the long-term effect is sure. But there may be some risk of relapse. The repetitive nerve stimulation test before transplantation is helpful in predicting the recovery of MG after APBSCT to some extent.The earlier and heavier the symptom is, the later it would disappear. The clinical symptoms recover faster than The index. The Clinical recovery donot stay the same with the high-low lines Of AchRab index.