非血缘脐血辅助亲缘单倍体异基因造血干细胞移植治疗急性髓系白血病的临床分析

Clinical analysis on combined allogeneic hematopoietic stem cell transplantation with unrelated cord blood for acute myeloid leukemia

目的：探讨非血缘脐血辅助亲缘单倍体异基因造血干细胞移植治疗急性髓系白血病的安全性和疗效。方法：回顾性分析2014年5月～2015年11月在我科行脐血辅助亲缘单倍体异基因造血干细胞移植治疗4例急性髓系白血病的临床资料，并复习相关文献。结果：4例患者移植后造血全部重建，中性粒细胞植入中位时间为13 d，血小板植入中位时间为15 d，移植后14 d外周血STR-PCR检测为100％供者；3例患者发生急性移植物抗宿主反应（aGVHD），其中2例发生Ⅱ度aGVHD，1例发生Ⅳ度aGVHD，随访至2016年4月，1例患者于移植后106 d死亡；3例患者存活。结论：非血缘脐血辅助亲缘单倍体异基因造血干细胞移植治疗急性髓系白血病临床安全，造血重建快，但aGVHD发生率较高，有待探索更有效的方法控制aGVHD的发生。

Objective：To investigate the efficacy and safety of combined allogeneic hematopoietic stem cell transplantation （ allo-HSCT） with unrelated um-bilical cord blood in the treatment of acute myeloid leukemia .Methods：The clinical data were retrospectively analyzed in 4 patients with acute myeloid leu-kemia undegone allo-HSCT with umbilical cord blood in our department between May 2014 and November 2015, and related literatures wer reviewed . Results：The hematopoietic function was restored in the 4 patients.The median time of neutrophil engraftment was 13 days and platelet engraftment,15 days.PCR analysis of the short tandem repeat（ STR） 14 days after transplantation indicated that peripheral blood chimerism was 100%of donor′s.Acute graft-versus-host diseases（ aGVHD） occurred in 3 patients,in whocm 2 were in degree II aGVHD and 1 in degree IV.Follow-up by April 2016 suggested one death by 106 days after transplantation,and survival of three.Conclusion：Allo-HSCT with unrelated umbilical cord blood may be an effective for acute myeloid leukemia,and lead to early restoration of teh lematopoietic function .However,this therapy may be associated with higher incidence of aGVHD of which managment of its advsere effect needs furter investigation .