【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 HIDallo-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。更多还原

【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.更多还原