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背景:异基因造血干细胞移植是治疗恶性血液病的一种非常有效的方法。单倍体相合的造血干细胞移植扩大了移植的应用范围,是无HLA相合供者患者的一种重要选择。目的:比较HLA单倍体相合与全相合异基因造血干细胞移植治疗恶性血液病的临床疗效。方法:回顾性分析接受异基因造血干细胞移植79例恶性血液病患者的临床资料,其中HLA单倍体相合组26例、全相合组53例,对比两组受者移植物抗宿主病的发生率、复发率、2年生存率等。结果与结论:78例受者获得完全、持久供者干细胞植入;1例受者在移植后28 d尚未植入,后因感染死亡。两组慢性移植物抗宿主病发生率、复发率和2年无病生存率差异无显著性意义(P>0.05)。单倍体相合组急性移植物抗宿主病发生率高于全相合组(P<0.05);2年总生存率低于全相合组(P<0.05)。提示血缘HLA单倍体相合移植治疗恶性血液病的安全性及疗效接近于全相合移植,在缺乏HLA相合供者的情况下,行HLA单倍体相合造血干细胞移植治疗恶性血液病是切实可行的选择。
Background: Allogeneic hematopoietic stem cell transplantation is a very effective method for the treatment of hematologic malignancies. Haploid haploidentical hematopoietic stem cell transplantation has expanded the scope of transplantation and is an important choice for patients without HLA-matched donors. Objective: To compare the clinical efficacy of HLA haploidentical and full heterozygous hematopoietic stem cell transplantation in the treatment of hematologic malignancies. Methods: The clinical data of 79 patients with hematological malignancies receiving allogeneic hematopoietic stem cell transplantation were retrospectively analyzed. Among them, 26 cases were HLA haploidentical matched group and 53 cases were all matched group. The incidence of graft-versus-host disease was compared between the two groups , Recurrence rate, 2-year survival rate and so on. RESULTS AND CONCLUSION: Seventy-eight recipients received complete and sustained donor stem cell implantation. One patient had not been implanted after 28 days and died of infection. There was no significant difference between the two groups in the incidence of chronic graft-versus-host disease, relapse rate and 2-year disease-free survival rate (P> 0.05). The incidence of acute graft-versus-host disease in haploidentical group was higher than that in the all-matched group (P <0.05). The 2-year overall survival rate was lower than that in the all-matched group (P <0.05). It is suggested that HLA haploidentical coincidence transplantation is safe and effective in treating hematologic malignancies. In the absence of HLA-matched donor, HLA haploidentical hematopoietic stem cell transplantation is feasible and feasible for the treatment of hematologic malignancies select.