单倍体造血干细胞移植治疗儿童重型再生障碍性贫血的研究进展

Research advances on haploidentical hematopoietic stem cell transplantation in the treatment of severe aplastic anemia in children

对于缺乏人类白细胞抗原(human leukocyteantigen,HLA)全相合同胞供者并且对免疫抑制疗法反应不佳的重型再生障碍性贫血患儿来说,单倍体造血干细胞移植是一种推荐的替代治疗方法。但由于HLA不全相合,患儿体内可能存在供者HLA特异性抗体,导致移植物功能不良发生率较高。与HLA全相合移植相比,其预处理方案的选择也仍需探讨。该文对单倍体造血干细胞移植中供者HLA特异性抗体的检测和处理、预处理方案的选择、移植物功能不良的机制及处理进行综述。

Haploidentical hematopoietic stem cell transplantation is a recommended alternative therapy for children with severe aplastic anemia who lack a human leukocyte antigen(HLA)-identical sibling donor and do not respond well to immunosuppressive therapy;however,due to non-identical HLA,the patients may have donor-specific anti-HLA antibody,which may lead to a relatively high incidence rate of poor graft function.Compared with HLA-identical transplantation,conditioning regimen for haploidentical transplantation still needs to be explored.This article reviews the detection and treatment of donor-specific anti-HLA antibody,the selection of conditioning regimen,and the mechanism and treatment of poor graft function in haploidentical hematopoietic stem cell transplantation.