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本研究旨在观察应用单倍体相合造血干细胞(hi-HSCT)联合脐带间充质干细胞(脐带MSC)移植治疗高危难治恶性血液病的疗效。对30例难治、复发或高危恶性血液病患者自愿接受单倍体相合造血干细胞联合脐带MSC移植的疗效进行分析,其中复发4例,高危26例。病种包括急性髓性白血病15例,急性淋巴细胞白血病9例,前T淋巴母细胞淋巴瘤/白血病3例,脾边缘带淋巴瘤ⅣB 1例,NK/T细胞淋巴瘤1例,Burkitt淋巴瘤ⅣB 1例。结果表明,30例全部获得了顺利植入,发生急性移植物抗宿主病(aGVHD)19例(63%),其中Ⅲ-Ⅳ6例(20%);发生慢性移植物抗宿主病(cGVHD)8/25(32%),其中广泛型1例,局限型7例;复发3例,复发时间在移植后中位数300 d(128-455 d);死亡8例,其中1例死于复发,2例死于ⅣaGVHD并同时复发,5例死于感染、脏器衰竭。结论:应用脐带MSC联合单倍体相合造血干细胞移植治疗高危难治恶性血液病可取得良好疗效。
This study aimed to observe the efficacy of haploidentical hematopoietic stem cell (hHCT) combined with umbilical cord mesenchymal stem cell (umbilical cord MSC) transplantation in the treatment of high-risk refractory hematologic malignancies. The curative effect of haploidentical HSCT combined with umbilical cord MSC transplantation was analyzed in 30 patients with refractory, recurrent or high-risk hematological diseases. Among them, 4 were recurrent and 26 were high-risk. The disease includes 15 cases of acute myeloid leukemia, 9 cases of acute lymphoblastic leukemia, 3 cases of pre-T lymphoblastic lymphoma / leukemia, 1 case of splenic margin lymphoma IVB, 1 case of NK / T cell lymphoma, 1 case of Burkitt’s lymphoma Ⅳ B in 1 case. Nineteen patients (63%) had acute graft-versus-host disease (aGVHD), including 6 cases (20%) of Ⅲ-Ⅳ and 8 cases of chronic graft-versus-host disease (cGVHD) / 25 (32%), of which 1 was extensive and 7 were localized; 3 were relapsed, with a median recurrence of 300 days (128-455 days) after transplantation; 8 died, of which 1 died of recurrence, 2 died of ⅣaGVHD and relapsed at the same time, and 5 died of infection and organ failure. Conclusion: The combination of umbilical cord MSC and haploidentical hematopoietic stem cell transplantation can be used to treat malignant hematological diseases with high risk and refractory disease.