减低剂量预处理方案在亲缘HLA单倍体相合造血干细胞移植中的应用  

Reduced-intensity conditioning regimen in HLA-haploidentical hematopoietic stem cell transplantation

作　　者：杨廷[1] 江明[2] 

机构地区：[1]新疆医科大学第一附属医院,新疆维吾尔自治区乌鲁木齐市830054 [2]新疆医科大学第一附属医院血液病中心新疆维吾尔自治区血液病研究所,新疆维吾尔自治区乌鲁木齐市830054

出　　处：《中国组织工程研究》2015年第6期955-961,共7页Chinese Journal of Tissue Engineering Research

基　　金：新疆维吾尔自治区高新技术项目(201317104)~~

摘　　要：背景:近年来减低剂量预处理异基因造血干细胞移植已被证明是安全有效的治疗手段,在同胞全相合和无关供者中应用逐年增多,它特别适合老年人或年轻人合并器官功能障碍的患者,然而由于找到HLA配型相合供体的概率不高,使得同胞全相合和无关供者减低剂量预处理异基因造血干细胞移植开展受限,而HLA不相合/单倍体供体则可以迅速找到,但减低剂量预处理的单倍体造血干细胞移植应用的报道还较少,国内尚未见报道,因此对减低剂量预处理的单倍体造血干细胞移植的开展情况进行综述非常重要。目的:综述减低剂量预处理在亲缘HLA单倍体造血干细胞移植中的应用现状。方法:以"减低剂量预处理方案、非清髓性预处理方案、HLA单倍体相合、造血干细胞移植和No-nmyeloablative conditioning,Reduced-intensity conditioning,HLA-haploidentical,Hematopoietic stem cell transplantation"为检索词,应用计算机检索1997至2014年万方数据库、CNKI和PubM ed数据库、外文医学信息资源检索平台检索关于减低剂量预处理在亲缘HLA单倍体造血干细胞移植中应用的相关文献,根据纳入标准和排除标准,最终选取25篇文献进行分析,全部为英文。结果与结论:减低剂量预处理异基因造血干细胞移植在HLA同胞全相合及无关供者中开展的较多且效果愈来愈好。减低剂量预处理的单倍体造血干细胞移植开展的较晚且报道较少,其植入、感染、移植相关死亡、移植物抗宿主病、长期无病生存率和总生存率等各个研究的结果差异较大,早期结果稍差,而近期总体情况有明显改善。目前看减低剂量预处理的单倍体造血干细胞移植是可行的,尤其对于找不到同胞相合及无关全相合供者的患者来说,HLA单倍体相合的血缘关系亲属成为最有潜力的干细胞来源。减低剂量预处理的单倍体造血干细胞移植保留较强的移植物抗白血病�BACKGROUND: Reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation(RIC-allo-HSCT) is proved being one of the effective methods to cure hematologic malignancies recently, which has been used more and more in patients with matched sibling or matched unrelated donor year by year. It is more suitable for elderly patients or younger patients combined with any organ dysfunction or complications. However, matched sibling and matched unrelated donors are not easy to be obtained for RIC-allo-HSCT. While HLA-haploidentical donor can be quickly found in family members for the patients who need receiving RIC-allo-HSCT. Fewer papers for reduced-intensity conditioning haploidentical hematopoietic stem cell transplantation(RIC-haplo-HSCT) have been reported in the world, and none in China, so the review for RIC-haplo-HSCT is necessary.OBJECTIVE: To reveiw the application of RIC-haplo-HSCT and its prospect.METHODS: Using 'nonmyeloablative conditioning, reduced intensity conditioning, HLA-haploidentical, hematopoietic stem cell transplantation' as key words, we retrieved Wanfang, CNKI and PubM ed databases, and foreign language search platform(1997-2014) by computer for literatures about RIC-haplo-HSCT. According to the inclusion and exclusion criteria, 25 articles in English were selected for our review ultimately.RESULTS AND CONCLUSION: This review shows that RIC-allo-HSCT with matched sibling and matched unrelated donor is widely used and has a better result increasingly. RIC-haplo-HSCT is carried out relatively late and less, and its engraftment, infection, transplant-related mortality, graft-versus-host disease, long-term disease-free survival and overall survival in the early period is a bit weak, but overall the situation has been recently improved significantly. Currently RIC-haplo-HSCT is feasible, especially for patients lack of matched sibling donor and matched unrelate donor, and HLA haploidentical donor becomes the most potential source of hematopoietic stem cells. RIC-haplo-HSCT retains st

关 键 词：造血干细胞移植 移植预处理 移植物抗宿主病 干细胞 移植 异基因造血干细胞移植 减低剂量预处理 亲缘HLA不相合/单倍体相合 

分 类 号：R457.7[医药卫生—治疗学]