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脐带间充质干细胞治疗儿童重型免疫性血小板减少症的探索性研究 被引量:3

Exploratory research of umbilical cord mesenchymal stem cell to treat severe immune thrombocytopenia in children
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摘要 目的探讨脐带间充质干细胞(UC-MSC)输注治疗儿童重型免疫性血小板减少症(s ITP)的疗效及安全性。方法采用UC-MSC治疗儿童s ITP 3例。发病年龄为3个月至4岁,初治时血小板计数为(1-7)×10^9/L,3例均为s ITP,均出现严重出血,激素及免疫抑制剂无效或依赖。后给予2-3次(1次/周)静脉输注非血缘UC-MSC,输注细胞量为(1-2)×10^6/kg。输注后密切监测血象及肝肾功能等各项指标,观察疗效及不良反应。结果随访时间15-45个月,3例在输注细胞后渐显效:第1例在输注细胞后20 d血小板达到65×10^9/L,随访4个月,血小板均维持在1×10^11/L以上;第2例在输注细胞后41 d血小板达105×10^9/L,之后血小板一直维持正常;第3例在输注第2次细胞后血小板渐上升至2×10^11/L以上。输注过程中1例出现面色发红,1例出现血压升高,随访至今无明显不良反应。结论 UC-MSC对儿童重型ITP有一定的疗效,能提高儿童的生活质量;有必要扩大病例数,进一步研究UC-MSC治疗儿童ITP的疗效及机制。 Objective To explore the efficacy and safety of umbilical cord mesenchymal stern cells (UC-MSC) infusion for children with severe immune thrombocytopenia (sITP). Methods Children aged 4 months to 4 years with severe immune thrombocytopenia (sITP) were enrolled. The platelet count before treatment was (1-7)× 10^9 / L. All patients have severe hemorrhagic symptoms. Treatment included corticosteroids and immunosuppressants. 2-3 doses of(1-2) ×10^6 UC-MSC/kg were given intravenously to each of the patients. After infusion the platelet count and biochemical parameters were closely monitored. Side effects were recorded. The literature was reviewed for the diagnosis and treatment of slTP, as well as the effect and theoretical basis of UC-MSC infusion for slTP. Results During the follow-up of 15 and 45 months, platelet count in 3 cases has increased. In the first case, the platelet count rose to 65× 10^9/L by 20 days after cell insusion and maintained above 1 × 10^11/L for 4 months. In the second case, platelet count progressively rose to 105× 10^9/L at 41 days after cell infusion, and that remained normal afterwards. In the process of infusion, the face of one patient became red due to allergic reaction possibly. Another patient suffered from high blood pressure. All cases had no obvious side effect after infusion. Cloclusion The preliminary results suggest that UC-MSC is effective for sITP in children. It can enhance the patients' quality of life. It is necessary to further explore the effect and mechanism of UC-MSC transplantation for sITP in large clinical trials.
出处 《中华细胞与干细胞杂志(电子版)》 2014年第4期15-19,共5页 Chinese Journal of Cell and Stem Cell(Electronic Edition)
关键词 血小板减少 间充质干细胞 免疫调节 治疗 Thrombocytopenia mesenchymal stem cell immunoregulation treatment
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参考文献18

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共引文献68

同被引文献35

  • 1Semple JW. T cell and cytokine abnormalities in patients with autoimmune thrombocytopenic purpura[J]. Transfus Apher Sci, 2003, 28(3):237-242.
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  • 3Aggarwal S, Pittenger MF. Human mesenchymal stem cells modulate allogeneic immune cell responses[J]. Blood, 2005, 105(4): 1815-1822.
  • 4Zhou H, Guo M, Bian C, et al. Efficacy of bone marrow- derived mesenchymal stem cells in the treatment of sclerodermatous chronic graft-versus-host disease: clinical report[J]. Biol Blood Marrow Transplant, 2010, 16(3):403-412.
  • 5Provan D, Stasi R, Newland AC, et al. International consensus report on the investigation and management of primary immune thrombocytopenia[J]. Blood, 2010, 115(2):168-186.
  • 6Le Blanc K, Frassoni F, Ball L, et al. Mesenchymal stem cells for treat-ment of steroid-resistant, severe, acute graft- versus-host disease: a phase II study[J]. Lancet, 2008, 371(9624):1579-1586.
  • 7Salem HK, Thiemermann C. Mesenchymal stromal cells:current understanding and clinical status[J]. Stem Cells, 2010, 28(3):585-596.
  • 8Yamout B, Hourani R, Salti H, et al. Bone marrow mesenchymal stem cell transplantation in patients with multiple sclerosis: a pilot study[J]. J Neuroimmunol, 2010, 227(1-2):185-189.
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