单倍体相合造血干细胞移植联合骨髓间充质干细胞输注治疗儿童重型再生障碍性贫血的临床观察

发布时间：2018-06-14 01:05

  本文选题：造血干细胞移植 + 间充质干细胞　； 参考：《中国实验血液学杂志》2017年04期

【摘要】：目的:探讨单倍体相合造血干细胞移植(haploidentical-HSCT,hi-HSCT)联合骨髓间充质干细胞(BMM SC)输注治疗儿童重型再生障碍性贫血(SAA)的疗效。方法:回顾性分析25例行hi-HSCT联合BM-M SC输注治疗儿童SAA的临床资料,观察移植后造血恢复及移植相关并发症。结果:25例患儿中性粒细胞均植入,植入中位时间为12(11-22)d,其中23例血小板植入,中位植入时间为21(11-130)d。16例发生急性移植物抗宿主病(a GVHD),其中11例为Ⅰ度,5例为Ⅱ-Ⅳ度,1例在移植后115 d死于累及皮肤、肠道及肝脏的Ⅳ度a GVHD,5例发生慢性GVHD(c GVHD),均为局限性c GVHD。发生CMV血症的有23例,无1例进展为CMV病。23例患儿发生EBV血症,且其中有3例发生移植后淋巴增殖性疾病,经利妥昔单抗治疗后均治愈。出血性膀胱炎发生9例,仅1例为Ⅲ度。22例发生感染,其中10例为肺部感染,4例为肝脏感染。1例发生格林-巴利综合征。1例出现自身免疫性溶血性贫血。22例患儿存活且脱离输血,中位随访时间为14(3-27)个月。结论:hi-HSCT联合BM-MSC输注治疗儿童SAA是安全、可行的。
[Abstract]:Objective: to investigate the efficacy of haploidentical-HSCThi-HSCT combined with bone marrow mesenchymal stem cell (BMM) in the treatment of severe aplastic anemia in children. Methods: the clinical data of 25 cases of children SAA treated with hi-HSCT combined with BM-M SC infusion were retrospectively analyzed and the hematopoietic recovery and transplantation related complications were observed. Results neutrophilic granulocytes were implanted in 25 cases of children. The median time of implantation was 12 ~ 11 ~ 22 d, of which 23 cases were implanted with platelets. The median implantation time was: acute graft-versus-host disease (21(11-130)d.16) occurred in 5 patients with acute graft-versus-host disease (GVHD). Among them, 11 cases were grade 鈪，

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