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º» ¼³¸í¼´Â Çѱ¹Èñ±Í¡¤ÇʼöÀǾàǰ¼¾ÅÍ¿¡¼ Á¦¾àȸ»çÀÇ Á¦Ç° ¼³¸í¼¸¦ ±Ù°Å·Î ÀÛ¼ºÇÑ °ÍÀ¸·Î ½ÄǰÀǾàǰ¾ÈÀüóÀÇ Çã°¡¿Í ¹«°üÇÕ´Ï´Ù.
·ùÄ«ÀÎÁÖ´Â ¹éÇ÷±¸(leukocyte) ¼ºÀåÀÎÀڷμ, ´ÙÀ½¿¡ »ç¿ëµÈ´Ù.
1. 55¼¼ ÀÌ»óÀÇ ±Þ¼º°ñ¼ö¼º¹éÇ÷º´(acute myeloid leukemia, AML) ¼ºÀΠȯÀÚ¿¡¼, À¯µµ Ç×¾ÏÈÇпä¹ý(induction chemotherapy) ÈÄ, È£Áß±¸ ȸº¹(neutrophil recovery) ½Ã°£À» ´ÜÃà½Ã۰í, ÁßÁõ ¹× »ý¸íÀ» À§ÇùÇÏ´Â °¨¿° ¹× »ç¸Á¿¡ À̸£´Â °¨¿°ÀÇ ¹ß»ý·üÀ» ³·Ãã.
2. ¼ºÀΠȯÀÚ¿¡¼, ¹éÇ÷±¸¼ººÐäÁý¼ú(leukapheresis)À» ÀÌ¿ëÇÑ ¼öÁý ¶Ç´Â ÀÚ°¡À̽Ä(autologous transplantation)À» ÅëÇØ Á¶Ç÷Àü±¸¼¼Æ÷(hematopoietic progenitor cells)¸¦ ¸»ÃÊÇ÷¾×(peripheral blood) ³»·Î À̵¿½ÃÅ´.
3. ¼ºÀÎ ¹× 2¼¼ ÀÌ»ó ¼Ò¾Æ ȯÀÚ¿¡¼, ÀÚ°¡ °ñ¼ö ¶Ç´Â ¸»ÃÊÇ÷¾× Àü±¸¼¼Æ÷ ÀÌ½Ä ÈÄ °ñ¼ö À籸¼º(myeloid reconstitution) ÃËÁø.
4. ¼ºÀÎ ¹× 2¼¼ ÀÌ»ó ¼Ò¾Æ ȯÀÚ¿¡¼, µ¿Á¾(allogeneic) °ñ¼ö ÀÌ½Ä ÈÄ °ñ¼ö À籸¼º ÃËÁø.
5. ¼ºÀÎ ¹× 2¼¼ ÀÌ»ó ¼Ò¾Æ ȯÀÚ¿¡¼, ÀÚ°¡ ¶Ç´Â µ¿Á¾ °ñ¼ö ÀÌ½Ä ÈÄ È£Áß±¸ ȸº¹ Áö¿¬ ¶Ç´Â ÀÌ½Ä ½ÇÆÐ(graft failure)ÀÇ Ä¡·á.
6. °ñ¼ö¾ïÁ¦ ¹æ»ç¼±·®(myelosuppressive doses of radiation)¿¡ ±Þ¼º ³ëÃâµÈ ¼ºÀÎ ¹× Ãâ»ý ÀÌÈÄ 17¼¼±îÁö ¼Ò¾Æ ȯÀÚÀÇ »ýÁ¸·üÀ» Áõ°¡½ÃÅ´ (±Þ¼º¹æ»ç¼±ÁõÈıºÀÇ Á¶Ç÷±â ÁõÈıº, Hematopoietic Syndrome of Acute Radiation Syndrome, H-ARS).
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* Àý´ë ÀÓÀǺ¹¿ëÇÏÁö ¸¶½Ã°í ¹Ýµå½Ã ÀÇ»ç ¶Ç´Â ¾à»ç¿Í »ó´ãÇϽñ⠹ٶø´Ï´Ù.
[󹿾à¾î]
1. ±Þ¼º°ñ¼ö¼º¹éÇ÷º´(AML), Ç×¾ÏÈÇпä¹ý ÈÄ È£Áß±¸ ȸº¹:
250mcg/m2/dayÀ» Á¤¸ÆÁÖ»ç·Î 4½Ã°£¿¡ °ÉÃÄ Åõ¿©.
2. ¸»ÃÊÇ÷¾× Àü±¸¼¼Æ÷ À̵¿:
250mcg/m2/dayÀ» Á¤¸ÆÁÖ»ç·Î 24½Ã°£¿¡ °ÉÃÄ Åõ¿©, ¶Ç´Â ÇÏ·ç 1ȸ ÇÇÇÏÁÖ»ç·Î Åõ¿©.
3. ¸»ÃÊÇ÷¾× Àü±¸¼¼Æ÷ ÀÌ½Ä ÈÄ:
250mcg/m2/dayÀ» Á¤¸ÆÁÖ»ç·Î 24½Ã°£¿¡ °ÉÃÄ Åõ¿©, ¶Ç´Â ÇÇÇÏÁÖ»ç 1ȸ·Î Åõ¿©.
4. ÀÚ°¡ ¶Ç´Â µ¿Á¾ °ñ¼öÀ̽Ä(BMT) ÈÄ °ñ¼ö À籸¼º:
250mcg/m2/dayÀ» Á¤¸ÆÁÖ»ç·Î 2½Ã°£¿¡ °ÉÃÄ Åõ¿©.
5. °ñ¼öÀÌ½Ä ½ÇÆÐ ¶Ç´Â »ýÂø(engraftment) Áö¿¬:
250mcg/m2/dayÀ» Á¤¸ÆÁÖ»ç·Î 2½Ã°£¿¡ °ÉÃÄ Åõ¿©Çϰí À̸¦ 14ÀÏ µ¿¾È ½Ç½Ã.
6. °ñ¼ö¾ïÁ¦ ¹æ»ç¼±·®(myelosuppressive doses of radiation)¿¡ ±Þ¼º ³ëÃâµÈ ȯÀÚ. ÇÇÇÏÁÖ»ç·Î 1ÀÏ 1ȸ Åõ¿©:
¼ºÀÎ ¹× üÁß > 40kgÀÎ ¼Ò¾Æ ȯÀÚ: 7mcg/kg, üÁß 15kg–40kgÀÎ ¼Ò¾Æ ȯÀÚ: 10mcg/kg, üÁß < 15kgÀÎ ¼Ò¾Æ ȯÀÚ: 12mcg/kg.
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°¡Àå ÈçÇÑ ºÎÀÛ¿ë(¹ß»ý·ü>30%)Àº ´ÙÀ½°ú °°´Ù.:
1) ÀÚ°¡ °ñ¼öÀ̽Ä(BMT) ȯÀÚ: ¹ß¿, ¸Þ½º²¨¿ò, ¼³»ç, ±¸Åä, Á¡¸· Àå¾Ö(mucous membrane disorder), Å»¸ð, ¹«·ÂÁõ, ºÒÄè°¨, ½Ä¿åºÎÁø, ¹ßÁø, À§ÀåÀå¾Ö, ºÎÁ¾
2) µ¿Á¾ °ñ¼öÀÌ½Ä È¯ÀÚ: ¼³»ç, ¹ß¿, ¸Þ½º²¨¿ò, ¹ßÁø, ±¸Åä, ±¸³»¿°, ½Ä¿åºÎÁø, Ç÷´ç »ó½Â, Å»¸ð, º¹Åë, ¾ËºÎ¹Î °¨¼Ò, µÎÅë, °íÇ÷¾Ð
3) ±Þ¼º°ñ¼ö¼º¹éÇ÷º´(AML) ȯÀÚ: ¹ß¿, °£ µ¶¼º, ÇǺΠ¹ÝÀÀ(skin reactions), °¨¿°, ´ë»ç °ü·Ã ½ÇÇè½Ç°Ë»ç¼öÄ¡ ÀÌ»ó(metabolic laboratory abnormalities), ¸Þ½º²¨¿ò, ¼³»ç, ºñ´¢»ý½Ä±â ÀÌ»ó, Æó µ¶¼º, ±¸Åä, ½Å°æµ¶¼º, ±¸³»¿°, Å»¸ð, üÁß °¨¼Ò.
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