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目的:探讨非血缘供者异基因外周血造血干细胞(URD-PBSC)和脐带间充质干细胞(UC-MSC)联合移植治疗恶性血液病的疗效及安全性。方法:回顾分析我院49例接受非血缘供者异基因外周血造血干细胞移植(URD-PBSCT)治疗恶性血液病患者的临床资料,其中包括急性非淋巴细胞白血病(ANLL)12例,急性淋巴细胞白血病(ALL)17例,慢性粒细胞白血病(CML)18例,骨髓增生异常综合征(MDS)2例。UC-MSC+URD-PBSCT组22例,URD-PBSCT组27例,UC-MSC+URD-PBSCT组平均回输UC-MSC数为1.0×106/kg。结果:与URD-PBSCT组相比,UC-MSC+URD-PBSCT组粒细胞植入中位时间短(12 d vs 15 d)(P=0.041);慢性移植物抗宿主病(cGVHD)发生率及严重程度低(20.0%vs 51.9%)(P=0.026);(5.0%vs 33.3%)(P=0.040);移植后巨细胞病毒(CMV)感染率高(81.8%vs 51.9%)(P=0.028)。两组之间移植后造血干细胞植入率,血小板重建,急性移植物抗宿主病(aGVHD)的发生率及严重程度,肺部感染,出血性膀胱炎,1年复发率及1年生存率无明显差异(P>0.05)。结论:联合UC-MSC的异基因造血干细胞移植安全、有效,粒细胞重建快,cGVHD发生率及严重程度低,但应注意防治CMV感染的发生。
Objective: To investigate the efficacy and safety of non-blood donor allogeneic peripheral blood hematopoietic stem cells (URD-PBSC) combined with umbilical cord mesenchymal stem cells (UC-MSC) in the treatment of hematologic malignancies. Methods: The clinical data of 49 patients with hematologic malignancies receiving non-blood donor allogeneic peripheral blood stem cell transplantation (URD-PBSCT) were retrospectively analyzed. Among them, 12 cases were acute non-lymphocytic leukemia (ANLL), acute lymphoblastic 17 cases of leukemia (ALL), 18 cases of chronic myeloid leukemia (CML) and 2 cases of myelodysplastic syndrome (MDS). UC-MSC + URD-PBSCT group, 22 cases, URD-PBSCT group, 27 cases UC-MSC + URD-PBSCT group, the average number of UC-MSCs transfused was 1.0 × 106 / kg. Results: Compared with the URD-PBSCT group, the median time of neutrophil implantation in UC-MSC + URD-PBSCT group was shorter (12 days vs 15 days) (P = 0.041), and the incidence of chronic graft versus host disease (cGVHD) (P = 0.026); (5.0% vs 33.3%) (P = 0.040); the infection rate of cytomegalovirus (CMV) was significantly higher after transplantation (81.8% vs 51.9%, P = 0.028). Hematopoietic stem cell engraftment, platelet reconstruction, incidence and severity of acute graft-versus-host disease (aGVHD), pulmonary infection, hemorrhagic cystitis, 1-year recurrence and 1-year survival after transplantation Significant difference (P> 0.05). CONCLUSION: Allogeneic hematopoietic stem cell transplantation combined with UC-MSCs is safe and effective, rapid granulocyte reconstruction and low incidence and severity of cGVHD. However, CMV infection should be prevented and treated.