吴亚妹, 曹永彬, 李晓红, 徐丽昕, 刘周阳, 刘蓓, 闫蓓, 杨雪良, 李松威, 樊世芬, 达万明, 高春记, 吴晓雄. 间充质干细胞联合单倍体造血干细胞移植治疗87例难治/复发恶性血液病临床疗效[J]. 解放军医学院学报, 2014, 35(11): 1081-1085,1159. DOI: 10.3969/j.issn.2095-5227.2014.11.001
引用本文: 吴亚妹, 曹永彬, 李晓红, 徐丽昕, 刘周阳, 刘蓓, 闫蓓, 杨雪良, 李松威, 樊世芬, 达万明, 高春记, 吴晓雄. 间充质干细胞联合单倍体造血干细胞移植治疗87例难治/复发恶性血液病临床疗效[J]. 解放军医学院学报, 2014, 35(11): 1081-1085,1159. DOI: 10.3969/j.issn.2095-5227.2014.11.001
WU Ya-mei, CAO Yong-bin, LI Xiao-hong, XU Li-xin, LIU Zhou-yang, LIU Bei, YAN Bei, YANG Xue-liang, LI Song-wei, FAN Shi-fen, DA Wan-ming, GAO Chun-ji, WU Xiao-xiong. Cotransplantation of haploidentical hematopoietic stem cells and umbilical cord mesenchymal stem cells (UC-MSCs) for patients with refractory/relapsed hematologic malignancy[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2014, 35(11): 1081-1085,1159. DOI: 10.3969/j.issn.2095-5227.2014.11.001
Citation: WU Ya-mei, CAO Yong-bin, LI Xiao-hong, XU Li-xin, LIU Zhou-yang, LIU Bei, YAN Bei, YANG Xue-liang, LI Song-wei, FAN Shi-fen, DA Wan-ming, GAO Chun-ji, WU Xiao-xiong. Cotransplantation of haploidentical hematopoietic stem cells and umbilical cord mesenchymal stem cells (UC-MSCs) for patients with refractory/relapsed hematologic malignancy[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2014, 35(11): 1081-1085,1159. DOI: 10.3969/j.issn.2095-5227.2014.11.001

间充质干细胞联合单倍体造血干细胞移植治疗87例难治/复发恶性血液病临床疗效

Cotransplantation of haploidentical hematopoietic stem cells and umbilical cord mesenchymal stem cells (UC-MSCs) for patients with refractory/relapsed hematologic malignancy

  • 摘要: 目的 回顾性分析难治/复发恶性血液病行脐带间充质干细胞(umbilical cord mesenchymal stem cells,UC-MSCs)联合单倍体异基因造血干细胞移植(haploidentical hematologic stem cells transplantation,haplo-HSCT)的临床疗效。 方法 总结解放军总医院第一附属医院血液科2007年1月-2013年12月住院收治的87例难治/复发恶性血液病进行UC-MSCs联合haplo-HSCT治疗的资料,观察移植后细胞植入、移植物抗宿主病(graft-versus-host disease,GVHD)发生率及严重程度和2年总生存率(overall survival,OS)、无疾病进展率(progression-free survival,PFS)及复发率。 结果 干细胞全部植入成功,无MSC回输不良事件发生。白细胞及血小板植入时间分别为12(9 ~ 21) d及14(10 ~ 28) d;Ⅱ~Ⅳ度和Ⅲ~Ⅳ度aGVHD发生率分别为34.5%和18.4%,cGVHD发生率为46.5%,广泛性仅为11.3%;2年OS、PFS和复发率为66.7%、62.9%及13.8%。59例存活,11例死于GVHD,9例死于感染,8例死于疾病复发。 结论 UC-MSCs联合haplo-HSCT对难治/复发恶性血液病患者有效,是具有高危因素、无全相合供者患者的挽救治疗选择。

     

    Abstract: Objective To analyse the clinical effect of cotransplantation of haploidentical hematopoietic stem cells and umbilical cord mesenchymal stem cells (UC-MSCs) for patients with refractory/relapsed hematologic malignancy. Methods Clinical data about 87 patients with refractory/relapsed hematologic malignancy who underwent haploidentical hematologic stem cells transplantation (haplo-HSCT) at The First Affiliated Hospital of Chinese PLA General Hospital from January 2007 to December 2013 were summarized. The engraftment, graft-versus-host disease (GVHD), overall survival (OS), disease/progression-free survival (PFS) and relapse after 2 years were observed. Results All patients given MSCs showed sustained hematopoietic engraftment without any adverse UC-MSC infusion-related reaction. The median time of transplantation of neutrophil> 0.50×109/L and platelet> 20×109/L engraftment was 12.0 days (9-21 days) and 14.0 days (10-28 days), respectively. GradeⅡtoⅣandⅢtoⅣ aGVHD was observed in 30 of 87 (34.5%) patients and 16 of 87 (18.4%), respectively. Chronic GVHD was observed in 33 of 71 (46.5%) patients and was extensive in 8 patients (11.3%). The probability that patients would attain 2-years OS, PFS and relapse was 66.7%, 62.9% and 13.8%, respectively. During follow-up for 1 to 79 months, 59 cases (67.8%) survived and 28 cases died, 9 patients died as a result of infection, 11 patients of GVHD and 8 patients of relapse. Conclusion Cotransplantation of haploidentical hematopoietic stem cells and UC-MSCs has good treatment effect to refractory/relapsed hematologic malignancy, and also it is a good survival opportunity for high-risk patients.

     

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