留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

非血缘脐血移植治疗高危急性白血病的临床研究

孙燕玲 李旭东 林东军 方志刚

孙燕玲, 李旭东, 林东军, 等. 非血缘脐血移植治疗高危急性白血病的临床研究[J]. 器官移植, 2015, 6(6): 420-424. doi: 10.3969/j.issn.1674-7445.2015.06.015
引用本文: 孙燕玲, 李旭东, 林东军, 等. 非血缘脐血移植治疗高危急性白血病的临床研究[J]. 器官移植, 2015, 6(6): 420-424. doi: 10.3969/j.issn.1674-7445.2015.06.015
Sun Yanling, Li Xudong, Lin Dongjun, et al. Clinical study on treatment of high-risk acute leukemia with unrelated cord blood transplantation[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 420-424. doi: 10.3969/j.issn.1674-7445.2015.06.015
Citation: Sun Yanling, Li Xudong, Lin Dongjun, et al. Clinical study on treatment of high-risk acute leukemia with unrelated cord blood transplantation[J]. ORGAN TRANSPLANTATION, 2015, 6(6): 420-424. doi: 10.3969/j.issn.1674-7445.2015.06.015

非血缘脐血移植治疗高危急性白血病的临床研究

doi: 10.3969/j.issn.1674-7445.2015.06.015
详细信息
    通讯作者:

    方志刚, Email:fzg92@163.com

  • 中图分类号: R617;R557

Clinical study on treatment of high-risk acute leukemia with unrelated cord blood transplantation

More Information
  • 摘要:   目的  探讨非血缘脐血移植(UCBT)治疗儿童和成人高危急性白血病的效果。  方法  对高危急性白血病10例患者进行脐血移植, 儿童3例, 成人7例, 中位年龄29岁(11~41岁)。6例接受单份脐血移植, 4例接受双份脐血移植。采用清髓性不含抗胸腺细胞球蛋白(ATG)预处理方案。在白消安(Bu)加环磷酰胺(Cy)基础上加用阿糖胞苷(Ara-C)、氟达拉滨(Flu)或全身照射(TBI)。移植物抗宿主病(GVHD)预防采用环孢素及吗替麦考酚酯。  结果  8例(80%)患者获得成功植入, 白细胞植入中位时间为19 d (14~25 d), 血小板植入中位时间为40 d (33~60 d)。3例患者发生急性GVHD, 无1例发生慢性GVHD。中位随访时间为24个月(1~29个月), 7例患者无病存活。2年总体存活率及无病存活率均为66.7%。  结论  UCBT治疗高危急性白血病是可行的, 对于无HLA相合同胞供者的高危患者, UCBT可作为首选, 其GVHD发生率低、复发率低, 有可能使急性白血病患者长期生存。

     

  • 图  1  10例非血缘脐血移植高危急性白血病患者术后生存曲线

    注:10例患者的2年总体存活率及无病存活率均为66.7%,生存曲线重叠

    Figure  1.  Survival curve of 10 patients of high-risk acute leukemia after unrelated cord blood transplantation

  • [1] Solh M. Haploidentical vs cord blood transplantation for adults with acute myelogenous leukemia[J]. World J Stem Cells, 2014, 6(4):371-379. doi: 10.4252/wjsc.v6.i4.371
    [2] Eapen M, Wagner JE. Transplant outcomes in acute leukemia.I.[J]. Semin Hematol, 2010, 47(1):46-50. doi: 10.1053/j.seminhematol.2009.10.007
    [3] Piñana JL, Sanz J, Esquirol A, et al. Umbilical cord blood transplantation in adults with advanced hodgkin's disease:high incidence of post-transplant lymphoproliferative disease[J]. Eur J Haematol, 2015, DOI:10.1111/ejh.12557[Epub ahead of print].
    [4] Tucunduva L, Ruggeri A, Sanz G, et al. Risk factors for outcomes after unrelated cord blood transplantation for adults with acute lymphoblastic leukemia:a report on behalf of Eurocord and the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation[J]. Bone Marrow Transplant, 2014, 49(7):887-894. doi: 10.1038/bmt.2014.72
    [5] Marks DI, Woo KA, Zhong X, et al. Unrelated umbilical cord blood transplant for adult acute lymphoblastic leukemia in first and second completeremission:a comparison with allografts from adult unrelated donors[J]. Haematologica, 2014, 99(2):322-328. doi: 10.3324/haematol.2013.094193
    [6] Ruqqeri A, Labopin M, Sanz G, et al. Comparison of outcomes after unrelated cord blood and unmanipulated haploidentical stem cell transplantationin adults with acute leukemia[J]. Leukemia, 2015, 29(9):1891-1900. doi: 10.1038/leu.2015.98
    [7] Robin M, Ruggeri A, Labopin M, et al. Comparison of unrelated cord blood and peripheral blood stem cell transplantation in adults with myelodysplastic syndrome after reduced-intensity conditioning regimen:a collaborative study from Eurocord (Cord Blood Committee of Cellular Therapy & Immunobiology Working Party of EBMT) and Chronic Malignancies Working Party[J]. Biol Blood Marrow Transplant, 2015, 21(3):489-495. doi: 10.1016/j.bbmt.2014.11.675
    [8] Sanz J, Boluda JC, Martin C, et al. Single-unit umbilical cord blood transplantation from unrelated donors in patients with hematological malignancy using busulfan, thiotepa, fludarabine and ATG as myeloablative conditioning regimen[J].Bone Marrow Transplant, 2012, 47(10):1287-1293. doi: 10.1038/bmt.2012.13
    [9] Scaradavou A, Brunstein CG, Eapen M, et al. Double unit grafts successfully extend the application of umbilical cord blood transplantation in adults with acute leukemia[J]. Blood, 2013, 121(5):752-758. doi: 10.1182/blood-2012-08-449108
    [10] Glucksberg H, Storb R, Fefer A, et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors[J]. Transplantation, 1974, 18(4):295-304. doi: 10.1097/00007890-197410000-00001
    [11] Fernandes JF, Rocha V, Labopin M, et al. Transplantation in patients with SCID:mismatched related stem cells or unrelated cord blood?[J]. Blood, 2012, 119(12):2949-2955. doi: 10.1182/blood-2011-06-363572
    [12] Danby R, Rocha V. Improving engraftment and immune reconstitution in umbilical cord blood transplantation[J]. Front Immunol, 2014, 5:68. http://cn.bing.com/academic/profile?id=2112888327&encoded=0&v=paper_preview&mkt=zh-cn
    [13] Delaney C, Heimfeld S, Brashem-Stein C, et al. Notch-mediated expansion of human cord blood progenitor cells capable of rapid myeloid reconstitution[J]. Nat Med, 2010, 16(2):232-236. doi: 10.1038/nm.2080
    [14] de Lima M, McNiece I, Robinson SN, et al. Cord-blood engraftment with ex vivo mesenchymal-cell coculture[J]. N Engl J Med, 2012, 367(24):2305-2315. doi: 10.1056/NEJMoa1207285
    [15] Zheng C, Zhu X, Tang B, et al. Comparative analysis of unrelated cord blood transplantation and HLA-matched sibling hematopoietic stem cell transplantation in children with high-risk or advanced acute leukemia[J].Ann Hematol, 2015, 94(3):473-480. doi: 10.1007/s00277-014-2213-y
    [16] Eapen M, Rocha V, Sanz G, et al. Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia:a retrospective analysis[J]. Lancet Oncol, 2010, 11(7):653-660. doi: 10.1016/S1470-2045(10)70127-3
    [17] Zheng C, Tang B, Tong J, et al. Unrelated cord blood transplantation for central nervous system relapse in high-risk childhood acute lymphoblastic leukemia[J]. Ann Hematol, 2013, 92(12):1665-1673. doi: 10.1007/s00277-013-1820-3
  • 加载中
图(1)
计量
  • 文章访问数:  76
  • HTML全文浏览量:  30
  • PDF下载量:  5
  • 被引次数: 0
出版历程
  • 收稿日期:  2015-09-20
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2015-11-15

目录

    /

    返回文章
    返回