人脐带间充质干细胞对急性淋巴细胞白血病患儿异基因干细胞移植后免疫重建的影响

发布时间：2018-02-26 10:23

本文关键词： 造血干细胞移植脐带间质干细胞移植白血病组织工程干细胞人脐带间充质干细胞儿童急性淋巴细胞白血病异基因造血干细胞移植免疫重建　出处：《中国组织工程研究》2017年29期 　论文类型：期刊论文

【摘要】：背景:人脐带间充质干细胞可分泌多种支持造血的细胞因子和生长因子,可改变造血微环境,具有调节及改善机体免疫功能的作用。目的:探讨人脐带间充质干细胞对儿童急性淋巴细胞白血病异基因造血干细胞移植后免疫重建的影响。方法:选取64例接受异基因造血干细胞移植治疗的急性淋巴细胞白血病患儿,分为非血缘性供者异基因造血干细胞移植组(allo-HSCT组,n=32)及非血缘性供者异基因造血干细胞移植后输注人脐带间充质干细胞组(allo-HSCT+MSCs组,n=32),观察两组治疗效果及并发症发生情况,比较两组患儿预处理前、移植后1,3,6个月时外周血免疫球蛋白及淋巴细胞亚群水平。结果与结论:①allo-HSCT+MSCs组粒细胞植入时间短于allo-HSCT组(P0.05),慢性移植物抗宿主病、巨细胞病毒感染生率低于allo-HSCT组(P0.05);②两组移植后造血干细胞植入率、血小板重建、累计复发率、1年存活率比较差异无显著性意义(P0.05);③allo-HSCT+MSCs组移植后1,3,6个月血清免疫球蛋白IgA、IgG、IgM、IgE水平及外周血T淋巴细胞(CD4~+、CD3~+CD4~+、CD4~+CD8~+)、B细胞(CD19~+)水平均高于allo-HSCT组(P0.05);④结果表明,联合人脐带间充质干细胞输注能有效降低急性淋巴细胞白血病患儿异基因造血干细胞移植慢性抗宿主病发生率,有助于粒细胞造血重建及免疫功能重建。
[Abstract]:Background: human umbilical cord mesenchymal stem cells can secrete a variety of cytokines and growth factors that support hematopoiesis and can change the hematopoietic microenvironment. Objective: to investigate the effect of human umbilical cord mesenchymal stem cells on immune reconstitution after allogeneic hematopoietic stem cell transplantation in children with acute lymphoblastic leukemia. Children with acute lymphoblastic leukemia treated by allogeneic hematopoietic stem cell transplantation, Allogeneic hematopoietic stem cell transplantation group (allo-HSCT group) and non-blood donor allogeneic hematopoietic stem cell transplantation group (non-blood donor allogeneic hematopoietic stem cell transplantation group) and non-blood donor allogeneic hematopoietic stem cell transplantation group were injected with human umbilical cord mesenchymal stem cells (HSCT MSCs group). The levels of peripheral blood immunoglobulin and lymphocyte subsets were compared between the two groups before preconditioning and at 1 and 6 months after transplantation. Results: the time of granulocyte implantation in the MSCs group was shorter than that in the allo-HSCT group. The infection rate of cytomegalovirus was lower than that of allo-HSCT group. There was no significant difference in the cumulative recurrence rate and the 1-year survival rate. The levels of serum immunoglobulin IgGN IgMMA IgE and peripheral blood T lymphocyte CD4 ~ + CD4 ~ CD4 ~ CD8 ~ + B cell CD19 ~ + were significantly higher in P0.05H MSCs group than those in allo-HSCT group at 1 and 6 months after transplantation. The combination of human umbilical cord mesenchymal stem cells infusion can effectively reduce the incidence of chronic versus-host disease after allogeneic hematopoietic stem cell transplantation in children with acute lymphoblastic leukemia.
【作者单位】：南阳市中心医院小儿血液科;
【基金】：河南省南阳市科技成果(16058080)~~
【分类号】：R733.71

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