单份与双份非亲缘脐血移植治疗血液疾病临床效果的比较

发布时间：2019-02-27 20:13

【摘要】：目的:分析比较单份与双份非亲缘脐血造血干细胞移植治疗血液疾病的临床效果。方法:回顾性分析2006年至2016年国内8家移植中心185例单份脐血干细胞移植(single-unit umbilical cord blood transplantation,SU-UCBT)与66例双份脐血干细胞移植(double-unit umbilical cord blood transplantation,DU-UCBT)病例临床资料,比较SU-UCBT和DU-UCBT 2种移植方式的植入率、中性粒细胞和血小板植入时间,恶性和非恶性血液病患者接受SU-UCBT和DU-UCBT后急性移植物抗宿主病(acute graft vs host disease,a GVHD)发生情况和受者生存率。结果:SU-UCBT和DU-UCBT受者植入率分别为78.9%和70.7%,其中恶性血液病患者植入率SU-UCBT为89.1%,DU-UCBT为82.5%。非恶性血液病患者SU-UCBT和DU-UCBT植入率分别为64.0%和53.8%,SU-UCBT和DU-UCBT的植入率相似(P0.05)。SU-UCBT和DU-UCBT受者中性粒细胞植入时间中位数都为18 d,血小板植入时间中位数分别为40 d和27 d,无显著差异(P0.05)。SU-UCBT和DU-UCBT受者Ⅰ、Ⅱ、Ⅲ和Ⅳ度a GVHD发生率分别为22.6%、22.6%、8.2%、12.3%和21.3%、14.9%、10.6%、10.6%,均无显著差异(均P0.05)。SU-UCBT和DU-UCBT受者中位生存时间分别为1 460 d(17~2 200 d)和988 d(21~2 200 d),6年累积存活率分别为42.5%和40.4%,无显著差异(P0.05)。结论:SU-UCBT和DU-UCBT植入成功患者的中性粒细胞和血小板植入时间、a GVHD发生率、存活时间及6年累积存活率均无显著差异,提示DU-UCBT是安全有效的移植选择。但仍需完善SU-UCBT和DU-UCBT评价体系及进一步探究DU-UCBT的植入机制,以便指导科学地选择UCBT方式。
[Abstract]:Objective: to analyze and compare the clinical effects of single and double unrelated cord blood hematopoietic stem cell transplantation (HSCT) in the treatment of blood diseases. Methods: the clinical data of 18 cases of single umbilical cord blood stem cell transplantation (single-unit umbilical cord blood transplantation,SU-UCBT) and 66 cases of double umbilical cord blood stem cell transplantation (double-unit umbilical cord blood transplantation,DU-UCBT) from 2006 to 2016 were retrospectively analyzed. The implantation rates of SU-UCBT and DU-UCBT, the time of neutrophil and platelet implantation, and the acute graft versus host disease (acute graft vs host disease,) after SU-UCBT and DU-UCBT were compared in patients with malignant and non-malignant hematological diseases. The occurrence of a GVHD) and the survival rate of recipients. Results: the implant rates of SU-UCBT and DU-UCBT recipients were 78.9% and 70.7%, respectively. The implantation rates of SU-UCBT and DU / UCBT in patients with hematological malignancies were 82.1% and 82.5%, respectively. The implantation rates of SU-UCBT and DU-UCBT in patients with non-malignant hematological diseases were 64.0% and 53.8%, respectively, and the implantation rates of SUU UCBT and DU-UCBT were similar (P0.05). The median time of neutrophil implantation in SU-UCBT and DU-UCBT recipients was 18 days. The median time of platelet implantation was 40 d and 27 d, respectively, and there was no significant difference (P0.05). The incidence of 鈪，

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