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单倍体相合造血干细胞移植治疗48例恶性血液病患者的临床分析

Clinical analysis of haploidentical hematopoietic stem cell transplantation in 48 patients with hematologic malignancies
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摘要 目的:探究恶性血液病患者行单倍体相合造血干细胞移植(haplo-HSCT)的临床疗效。方法:本研究共纳入48例患者,均采用粒细胞集落刺激因子动员外周血干细胞作为移植物的非体外去T细胞移植模式。结果:48例患者均获粒系及巨核系重建,中性粒细胞植活的中位时间为14(9~38)d,血小板植活的中位时间为16.5(9~49)d。移植后第100天时急性移植物抗宿主病(aGVHD)累积发生率为16.5%,其中Ⅲ~Ⅳ度aGVHD累积发生率为6.7%。43例患者移植后存活时间超过100d,慢性移植物抗宿主病(cGVHD)的2年累积发生率为28.6%,其中广泛型cGVHD为12.6%。2年累积复发率及累积非复发死亡率分别为23.7%、30.2%。2年及3年累积总体生存率和累积无病生存率分别为52.6%和44.5%、37.5%和33.8%。结论:非体外去T细胞的haplo-HSCT对恶性血液病患者的治疗有效,且仅用外周血干细胞与骨髓+外周血干细胞做移植物在haploHSCT中的效果无明显差异。 Objective:To investigate the clinical efficacy of haploidentical hematopoietic stem cell transplantation(haplo-HSCT)in patients with malignant hematopathy.Method:A total of 48 patients were enrolled in this study.The granulocyte colony-stimulating factor was used to mobilize peripheral blood stem cells as grafts without in vitro T cell depletion.Result:All the 48 patients achieved neutrophil recovery and megakaryocyte reconstitution.The median time of neutrophil engraftment was 14(9 to 38)days.The median time of platelet engraftment was16.5(9 to 49)days.The cumulative incidence of acute GVHD(aGVHD)on the first 100 days after transplantation(+100 d)was 16.5%,and that of gradeⅢ-ⅣaGVHD was 6.7%.Forty-three patients were survived beyond the+100 d,the 2-year cumulative incidence of total chronic GVHD(cGVHD)was 28.6%,and that of extensive cGVHD was 12.6%.The 2-year cumulative incidences of relapse and nonrelapse mortality were 23.7% and30.2%,respectively.The cumulative incidences of overall survival and disease-free survival at 2 and 3 years were52.6% and 44.5%,37.5% and 33.8%,respectively.Conclusion:The results showed that haplo-HSCT without in vitro T cell depletion is an effective method for hematologic malignancies,and there is no significant difference in the effect of grafts with peripheral blood stem cells and bone marrow + peripheral blood stem cells in haploHSCT.
作者 舒潇泓 唐晓琼 王利 张红宾 肖青 廖明燕 罗业涛 张梦 罗洁 刘林 SHU Xiaohong;TANG Xiaoqiong;WANG Li;ZHANG Hongbin;XIAO Qing;LIAO Mingyan;LUO Yetao;ZHANG Meng;LUO Jie;LIU Lin(Department of Hematology,the First Affiliated Hospital of Chongqing Medical University,Chongqing,400016,China;Department of Biostatistics,School of Public Health and Management,Chongqing Medical University)
出处 《临床血液学杂志》 CAS 2019年第1期36-40,共5页 Journal of Clinical Hematology
基金 国家自然科学基金面上项目(No:81570109).
关键词 造血干细胞移植 单倍体 非体外去T细胞 移植物抗宿主病 复发 hematopoietic stem cell transplantation haploidentical without in vitro T cell depletion graft-ver sus-host disease relapse
作者简介 通信作者:刘林,E-mail:Liul7776@aliyun.com.
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