单倍型相合造血干细胞移植治疗恶性血液病与人类白细胞抗原相合同胞移植疗效相当

doi:10.3969/j.issn.1004-583X.2017.08.006

临床荟萃

单倍型相合造血干细胞移植治疗恶性血液病与人类白细胞抗原相合同胞移植疗效相当

河北医科大学第二医院血液科，河北石家庄 050000

出版日期:2017-08-05 发布日期:2017-08-10
通讯作者: 通信作者：温树鹏，Email: hebih@126.com

Haploidentical hematopoietic stem cell transplantation for hematologic malignancies is equivalent to HLA matched sibling transplantation

Department of Hematology，the Second Hospital of Hebei Medical University，Shijiazhuang 050000，China

Online:2017-08-05 Published:2017-08-10
Contact: Corresponding author：Wen Shupeng，Email：hebih@126.com

摘要/Abstract

摘要： 目的对单倍型相合造血干细胞移植（HaploSCT）及人类白细胞抗原相合同胞造血干细胞移植（human leukocyte antigen matched sibling donor transplantation， MSDT）治疗恶性血液病进行临床观察，对比分析两者疗效。方法回顾性分析2012年7月至2016年12月在我院接受异基因造血干细胞移植的恶性血液病患者58例，HaploSCT组33例，同期MSDT组25例，分析影响移植后生存的相关危险因素。结果 ①HaploSCT组与MSDT组移植后均获得造血重建。②两组Ⅱ~Ⅳ度急性移植物抗宿主病（acute graft versus host disease，aGVHD）的累积发生率分别为33.3%和24%（P=0.261），Ⅲ~Ⅳ度aGVHD累积发生率分别为18.2%和8%（P=0.611）。③两组1年无白血病生存（leukemiafree survival，LFS）率分别为77%和61%（P=0.211），2年总生存（overall survival，OS）率分别为72%和61%（P=0.118）。④多因素分析显示移植后复发是影响OS的危险因素。结论对于缺乏HLA相合同胞供者的恶性血液病患者而言，单倍型相合供者是可供选择的干细胞来源。

关键词: 造血干细胞移植, 血液肿瘤, 移植物抗宿主病

Abstract: Objective To compare the clinical efficacy for treatment of malignant hematological disease in haploidentical hematopoietic stem cell transplantation (HaploSCT) and human leukocyte antigen identical sibling hematopoietic stem cell transplantation (human leukocyte antigen matched sibling donor transplantation， MSDT). Methods Fiftyeight patients with hematologic malignancies undergoing related haploidentical (n=33) and HLAidentical sibling (n=25) in our hospital were enrolled for a retrospective analysis. The clinical efficacy and related risk factors of post transplantation overall survival（OS） were analyzed. The therapeutic effects of the two treatments and the risk factors related to overall survival (OS) were evaluated.Results ①Haploidentical and identical sibling cohorts were successfully engrafted. ②The cumulative incidences of grades Ⅱ to Ⅳ acute graftversushost disease (aGVHD) and grades Ⅲ to Ⅳ aGVHD in the mismatched and matched cohorts were 33.3% versus 24%(P=0.261) and 18.2% versus 8%(P=0.611)， respectively. ③Oneyear leukemiafree survival (LFS) and twoyear OS in mismatched and matched cohorts were 77% vs 61% (P=0.211) and 72% vs 61% (P=0.118)， respectively. ④Multivariate analysis showed that only relapse after alloHSCT (P=0.033) were risk factors for OS.Conclusion For patients with hematological malignancies lacking matched sibling donor，HLAhaploidentical donors were an alternative stem cell source.

Key words: haploidentical stem cell transplantation, hematologic neoplasms, graftversushost disease

高欣宝，温树鹏，邢丽娜，牛志云，王颖，王福旭，张学军. 单倍型相合造血干细胞移植治疗恶性血液病与人类白细胞抗原相合同胞移植疗效相当[J]. 临床荟萃, doi: 10.3969/j.issn.1004-583X.2017.08.006.

Gao Xinbao， Wen Shupeng， Xing Lina， Niu Zhiyun， Wang Ying， Wang Fuxu， Zhang Xuejun. Haploidentical hematopoietic stem cell transplantation for hematologic malignancies is equivalent to HLA matched sibling transplantation[J]. Clinical Focus, doi: 10.3969/j.issn.1004-583X.2017.08.006.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2017.08.006

https://huicui.hebmu.edu.cn/CN/Y2017/V32/I8/665

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单倍型相合造血干细胞移植治疗恶性血液病与人类白细胞抗原相合同胞移植疗效相当

Haploidentical hematopoietic stem cell transplantation for hematologic malignancies is equivalent to HLA matched sibling transplantation

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