单倍型异基因造血干细胞-脐带间充质干细胞联合移植治疗1例急性白血病

Transplantation of combined haplo-hematopoietic and human umbilical cord-derived mesenchymal stem cells for acute leukemia:A case report

  • 摘要: 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。

     

    Abstract: Objective To investigate the effect of combined transplantation of human umbilical cord derived mesenchymal stem cells(hUC-MSCs)and hematopoietic stem cells on acute myloid leukemia. Methods The patient with acute myloid leukemia received marrow and peripheral blood stem cell transplantation(UD-PBSCT)with granulocyte clony-stimulating factor(G-CSF).hUC-MSCs were isolated,culture-expanded from human umbilical cord after enzyme digestion,and cotransplantation to patient with haplo-hematopoietic stem cells.The donor of haplo-hematopoietic stem cells was her elder-brother.Graft-versus-host disease(GVHD)was prevented with CsA,MTX,ATG,CD25 and mycophenolate mofetial. Results The number of MNCs and CD34+ cells was 7.92×108/kg and 4.1×106/kg,respectively in the donor.The number of neutrophils and platelets was over 0.5×109/L and 20×109/L on days 14 and 15,respectively.On day 24,the chimeras accounted for 100%.Grade 1 aGVHD was observed on about day 40,and no other severe complications occurred after treatment. Conclusion Transplantation of combined haplo-hematopoietic stem cells and hUC-MSCs is safe and simple,and can promote the function recovery of hematopoietic cells.

     

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