脐带间充质干细胞联合HLA单倍型相合造血干细胞治疗重型再生障碍性贫血的临床观察

Observation of transplantation of combined human umbilical cord derived mesenchymal stem cells and HLA haploidentical hematopoietic stem cells for aplastic anemia

目的观察人脐带间充质干细胞(HUC-MSC)在联合人类白细胞抗原(HLA)单倍型相合移植治疗重型再生障碍性贫血的疗效和安全性。方法对8例重型再生障碍性贫血患者进行HUC-MSC联合HLA单倍型相合移植治疗,观察移植疗效及相关并发症。结果所有患者均重建供者造血,中性粒细胞大于0.5×109/L和血小板大于20×109/L的恢复中位时间分别为12.1d和15.2d。8例患者均出现粒细胞缺乏症伴感染,1例(12.5%)发生急性移植物抗宿主病(aGVHD),予甲泼尼松龙和布地奈德后治疗控制。巨细胞病毒(CMV)感染1例,无1例发生肝静脉闭塞病(VOD)。结论 HUC-MSC联合HLA单倍型相合移植治疗重型再生障碍性贫血安全有效,可加快造血重建。

Objective To investigate the efficacy and safety of transplantation of combined human umbilical cord derived mesenchymal stem cells and HLA haploidentical hematopoietic stem cells for aplastic anemia. Methods Eight patients with AA were car- ried out and treated with transplantation of combined human umbilical cord derived mesenchymal stem cells and HLA haploidentical hematopoietic stem cells, and the efficacy and correlated complication were observed. Results When the neutrophils count and platelet count in patients respectively reached more than 0.5 × 10^9/L and 20 × 10^9/L, the median time were 12. 1 days and 15.2 days after transplantation respectively. 8 patients occured agranulocytosis, and Acute GVHD developed in one case（12.5%） was finally controlled by Methylprednisolone and budesonide. One case occured CMV infection, while there was no VOD in all 8 eases. Conclusion The transplantation of combined human umbilical cord derived mesenchymal stem ceils and HLA haploidentical hematopoietie stem cells for aplastic anemia was effective,and can promote the function recovery of hematopoietic cells.