亲缘供者脐血加异基因骨髓混合移植治疗骨髓增生异常综合征

Incorporated transplantation of relative-associated matched cord blood and allogene bone marrow stem cell for myelodysplastic syndrome

目的探讨亲缘供者脐血加异基因骨髓混合移植治疗骨髓增生异常综合征(MDS)的可行性方案和疗效。方法采用有亲缘关系的胞妹脐血加异基因骨髓混合移植治疗MDS女性患儿1例。预处理方案为环磷酰胺、马利兰、抗淋巴细胞球蛋白,以短疗程CD25单抗、环孢菌素A和霉酚酸酯预防移植物抗宿主病(GVHD)。结果+18d中性粒细胞升至0.5×109/L,+28d白细胞升至4.2×109/L,+42d血小板升至34×109/L。+30、+90d经STR-PCR检测均为完全供者型。无GVHD发生。现患儿移植后健康生存时间达1a4个月。结论有亲缘关系的HLA相合的脐血加异基因骨髓的混合移植治疗MDS是可行的。

[Objective]To explore the feasible project and curative effect of relative-associated matched cord blood and allogene bone marrow stem cell for myelodysplastic syndrome （MDS）. [Methods] One girl patient with MDS received her sister＇s matched cord blood and allogene bone marrow stem cell. Primed project was cyclophosphamide （CY）, busulfan （BU） and antithymocyte globulin （ALG）. And graft-versus-host disease （GVHD） was obviated by short-term use of anti-CD25, cyclosporine A （CsA） and Mycophenolate Mofetil （MMF）. [Results] The Neutrophil cell was increased to 0. 5× 10^9/L on 18th day, and to 4.6 × 10^9/L on 28th day,and to 34 × 10^9/L on 42th day. They were full donor type engraftmen by STR-PCR analysis on 30th day, 90th day and without GVHD. Their healthy live time reached to one year and four months after transplantation. [Conclusion] The relative-associatied HLA matched cord blood stem cell combinated with bone marrow stem cell transplantation is feasible for MDS patients.