减低强度预处理非血缘脐血移植在恶性血液病中的应用

Application of unrelated umbilical cord blood transplantation with reduced-intensity conditioning in treatment of hematological malignancies

非血缘脐血移植（UCBT）以脐血纯净、易获取等移植优势逐渐被大众接受，为造血干细胞移植（HSCT）提供更广泛的移植物选择范围。为降低复发率，UCBT常采用清髓性预处理（MAC）方案，但是此类方案对患者的身体健康状态要求较高，同时可导致移植相关死亡率（TRM）升高。而减低强度预处理（RIC）方案不仅适用于老年患者或者身体状况较差的UCBT患者，并且可明显降低TRM，提高UCBT患者术后生存质量。笔者对近年来RIC—UCBT在恶性血液病治疗中的发展和应用进行综述，旨在为促进该移植方法的成熟及发展提供理论依据。

The unrelated umbilical cord blood transplantation （UCBT） has been accepted by the public for the purity of umbilical cord blood, easy to obtain and so on, which provides a wider range of choice for hematopoietic stem cell transplantation （HSCT）. Most of UCBT choose myeloablative conditioning （MAC） to reduce the relapse rate. MAC can increase the transplantation-related mortality （TRM）, and it requires patients with good health status. But reduced-intensity conditioning （RIC） not only could be used to elderly or poor-body-condition patients, but also have lower TRM and enhance the quality of post-transplantation patients＇ lives. In this paper, progress and problems of RIC-UCBT in treating malignant hematological diseases are reviewed.