河北医科大学学报 ›› 2021, Vol. 42 ›› Issue (7): 779-783.doi: 10.3969/j.issn.1007-3205.2021.07.007

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HLA全相合供者与亲缘单倍体供者异基因造血干细胞移植治疗输血依赖的非重型再生障碍性贫血效果比较

  

  1. 1.河北医科大学第二医院血液科，河北 石家庄 050000；2.河北医科大学第二医院儿科，河北 石家庄 050000
  • 出版日期:2021-07-25 发布日期:2021-08-02
  • 作者简介:王颖（1972-），女，河北衡水人，河北医科大学第二医院主任医师，医学博士，从事血液科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题计划(20170611) 

Comparison of the effect of allogeneic hematopoietic stem cell transplantation between human leucocyte antigen-matched donor and haploidentical donor on patients with transfusion-dependent non-severe aplastic anemia 

  1. 1.Department of Hematology, the Second Hospital of Hebei Medical University, Shijiazhuang 
    050000, China; 2.Department of Pediatrics, the Second Hospital of Hebei Medical 
    University, Shijiazhuang 050000, China
  • Online:2021-07-25 Published:2021-08-02

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摘要： 目的 比较HLA全相合供者(human leucocyte antigen-matched donor realated or unrelated donor,HLA-MR/UD)与亲缘单倍相合（haploidentical donor,HID）异基因造血干细胞移植（allogeneic hematopoietic stem cell transplantation,allo-HSCT）治疗输血依赖的非重型再生障碍性贫血(transfusion dependent non-severe aplastic anemia,TD-NSAA)的效果。
方法 回顾性分析行allo-HSCT治疗的TD-NSAA患者14例的临床资料，根据供者来源分为亲缘单倍体移植组（HID组）和全相合亲缘或无关供者移植组（matched donor realated or unrelated donor,MR/UD组），比较2组植入率、植入时间、移植治疗相关死亡、移植相关并发症、总体生存率等，评价2种方法治疗TD-NSAA中的效果。
结果 HID组急性移植物抗宿主病(acute graft-versus-host-disease,aGVHD)发生率高于MR/UD组（P＜0.05）,主要体现在Ⅰ~Ⅱ度aGVHD。2组病史特征、回输造血干细胞计数、造血干细胞植活时间、嵌合状态、移植相关并发症（除外Ⅰ~Ⅱ度aGVHD）、3年总生存率（overal survival,OS）率及无病生存率（disease free survival,DFS）率差异均无统计学意义（P＞0.05）。
结论 HID  allo-HSCT与全相合亲缘或无关供者allo-HSCT对TD-NSAA的疗效相当，在骨髓库中或同胞全合中未成功匹配患者可以考虑HID allo-HSCT。


关键词: 贫血, 再生障碍性, 造血干细胞移植, 供者选择

Abstract: Objective To compare the effect of allogeneic hematopoietic stem cell transplantation(allo-HSCT) between human leucocyte antigen(HLA)-matched donor and haploidentical donor(HID) in the treatment of transfusion-dependent non-severe aplastic anemia(TD-NSAA). 
Methods Clinical data of 14 TD-NSAA patients treated with allo-HSCT were retrospectively analyzed, and they were divided into HID group and HLA-matched donor related or unrelated donor(MR/UD) group according to donor origin. Implantation rate, implantation time, transplantation-related death, transplantation-related complications, and overall survival(OS) of two groups were compared, and the efficacy of two methods in the treatment of TD-NSAA was evaluated. 
Results The incidence of acute graft-versus-host-disease(aGVHD) in HID group was higher than that in MR/UD group(P＜0.05), which was mainly reflected in aGVHD of Ⅰ-Ⅱ. There were no significant differences in medical history, hematopoietic stem cell count, survival time after hematopoietic stem cell transplant, chimeric status, transplant-related complications(except Ⅰ-Ⅱ aGVHD), 3-year OS,OS and disease-free survival between two groups(P＞0.05). 
Conclusion The efficacy of HID allo-HSCT in TD-NSAA is comparable to that of MR/UD, and HID allo-HSCT should be considered in patients who were not successfully matched in the myeloid bank or sibling donor. 


Key words: anemia, aplastic, hematopoietic stem cell transplantation, donor selection

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