脐带血移植治疗儿童血液病疗效的回顾性分析

发布时间：2018-05-11 18:13

  本文选题：脐带血移植 + 血液病　； 参考：《临床儿科杂志》2017年10期

【摘要】：目的观察脐带血治疗儿童血液病的治疗效果及预后。方法回顾分析2011年1月至2016年6月期间51例接受脐带血移植患儿的临床资料。结果 51例患儿中,男34例、女17例,中位年龄62个月;恶性血液病32例,非恶性血液病19例。2例在粒细胞未重建时死亡,4例发生原发性植入失败,45例植入成功。粒细胞植入中位时间16天,血小板植入中位时间23天。围植入综合征发生率46.94%,围植入综合征患儿移植后100天内以及长期总生存率(OS)分别为(73.9±9.2)%和(50.2±11.7)%,均低于无围植入综合征患儿的OS 100%,差异有统计学意义(P0.01)。急性移植物抗宿主病(aGVHD)发生率为55.10%,其中II~Ⅲ度aGVHD占28.57%,Ⅳ度aGVHD 26.53%;Ⅳ度aGVHD患儿移植100天内OS为(61.5±13.5)%;Ⅲ和Ⅳ度aGVHD患儿的长期OS分别为(75.0±21.7)%和(44.9±14.1)%,未发生aGVHD患儿的长期OS为(90.2±6.6)%,差异有统计学意义(χ2=14.35,P=0.002)。慢性GVHD(c GVHD)发生率为28.57%;c GVHD患儿的长期OS为(72.7±13.4)%,无c GVHD患儿100%存活。脐血移植后100天内OS(86.0±4.9)%;脐血移植长期OS(77.9±6.3)%,其中恶性血液病为(76.6±7.8)%,非恶性血液病为(79.5±11.3)%。恶性血液病中急性淋巴细胞白血病(ALL)的OS为(87.5±11.7)%,急性髓细胞白血病(AML)为(76.7±10.3)%,骨髓增生异常综合征(MDS)为(33.3±27.2)%。结论脐带血移植是治疗儿童血液病的有效手段,重视围植入综合征的处理,积极防治Ⅲ/Ⅳ度aGVHD和c GVHD是提高脐带血移植疗效的重要策略。
[Abstract]:Objective to observe the therapeutic effect and prognosis of umbilical cord blood in children with hematopathy. Methods the clinical data of 51 children with umbilical cord blood transplantation from January 2011 to June 2016 were retrospectively analyzed. Results among the 51 children, 34 were male, 17 were female, the median age was 62 months, 32 were malignant hematopathy and 19 were non-malignant hematopathy. 4 patients died of failure of primary implantation without granulocyte reconstruction. The median time of granulocyte implantation was 16 days and that of platelet implantation was 23 days. The incidence of periimplantation syndrome was 46.94. The overall survival rate within 100 days after transplantation and the long-term overall survival rate were 73.9 卤9.2% and 50.2 卤11.7%, respectively, which were lower than those in the patients without peri-implantation syndrome (P 0.01). The incidence of acute graft-versus-host disease (aGVHD) was 55.100.The incidence of grade II- 鈪，

本文编号：1875031