非血缘及HLA配型不合造血干细胞移植的临床研究

Treatment of leukemia by unrelated donor or HLA mismatched hematopoietic stem cell transplantation

目的探讨非血缘及HLA配型不全相合造血干细胞移植在白血病治疗中的应用。方法非血缘脐血移植治疗儿童白血病3例,非血缘异基因外周血造血干细胞移植治疗白血病1例,HLA配型不全相合外周血造血干细胞移植治疗白血病1例。结果5例患者完全植入,+15～+25天白细胞(WBC)>1.0×109/L,+35～+51天血小板(Plt)>20×109/L。例1出现急性移植物抗宿主病(aGVHD)Ⅰ度;例4aGVHDⅣ度;例5出现肝静脉闭塞综合征(VOD)、aGVHDⅠ度、出血性膀胱炎(HC);例2移植后6个月复发,放弃治疗死亡;余4例正常生活或工作。结论非血缘及HLA配型不全相合造血干细胞移植治疗白血病是安全有效的。

Objective To investigate the application of unrelated donor and HLA mismatched hematopoietic stem cell transplants for the treatment of leukemia. Methods Three children with leukemia received unrelated umbilical cord blood transplantation（UBCT）. One patient with leukemia received unrelated donor peripheral blood stem cell transplantation（PBSCT）. The other received peripheral blood stem cell transplantation（PBSCT） with HLA mismatched family donor. Results Hematopoietic function recovered to〉1.0 10×10^9/L of leukocyte at 15-25 days and to 〉20×10^9/L of platelet at 35-51days in all patients. Case 1 had developed grades-Ⅰ aGVHD. Grades-Ⅳ aGVHD occurred in case 4. Case 5 had developed VOD, grades- Ⅰ aGVHD, HC. Case 2 died of replase at six months after transplantation, the others are surviving. Conclusion Unrelated donor and HLA mismatched hematopoietic stem cell transplantation （HSCT） is an effective and safe treatment for leukemia.