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目的研究急性粒细胞白血病异基因造血干细胞-人脐带源间充质干细胞(hUC-MSC)联合移植效果。方法急性髓性白血病-M2,供者为其胞兄,HLA单倍型相合,移植物为经粒细胞集落刺激因子(Granulocyte Clony-Stimulating Factor,G-CSF)动员的骨髓以及外周血造血干细胞,加入分离、扩增的hUC-MSC。移植物抗宿主病(Graft-Versus-Host Disease,GVHD)预防采用环孢菌素A+ATG+霉酚酸酯+短程甲氨喋呤和CD25单抗。结果输注供者的MSC总数和CD34细胞数分别为7.92×108/L和3.78×106/L。中性粒细胞大于0.5×109/L和血小板大于20×109/L的时间分别为14d和15d。24d嵌合体100%,40d左右出现I度aGVHD,治疗后好转,未出现其他严重并发症。结论异基因造血干细胞-人脐带源间充质干细胞(hUC-MSC)联合移植安全简便,可加速造血功能恢复。
Objective To investigate the combined effect of hUC-MSCs transplantation on acute myeloid leukemia allogeneic hematopoietic stem cells-human umbilical cord-derived mesenchymal stem cells (hUC-MSCs). Methods Acute myeloid leukemia-M2 was obtained from the donor’s sibling and HLA-haplotype combination. The grafts were bone marrow mobilized from granulocyte colony-stimulating factor (G-CSF) and peripheral blood hematopoietic stem cells. The isolated, expanded hUC-MSCs were added. Graft-Versus-Host Disease (GVHD) prophylaxis with cyclosporin A + ATG + mycophenolate + short-range methotrexate and CD25 mAb. Results The total number of transfused MSCs and CD34 cells were 7.92 × 108 / L and 3.78 × 106 / L, respectively. Neutrophils greater than 0.5 × 109 / L and platelets greater than 20 × 109 / L time was 14d and 15d. 24d chimera 100%, 40d appeared I degree aGVHD, improved after treatment, no other serious complications. Conclusion Allogeneic hematopoietic stem cell-human umbilical cord-derived mesenchymal stem cells (hUC-MSC) combined transplantation is safe and convenient, and can accelerate the recovery of hematopoietic function.