自体骨髓间充质干细胞联合造血干细胞共移植治疗恶性血液病五例疗效观察  

Autologous bone marrow-derived mesenchymal stem cells and peripheral blood stem cells cotransplantation in treatment of hematological malignant diseases

作　　者：吴涛[1] 白海[1] 王存邦[1] 张茜[1] 澹台林芳[1] 王晓靖[1] 欧建锋[1] 赵强[1] 

机构地区：[1]兰州军区兰州总医院全军血液病中心,730050

出　　处：《中华内科杂志》2009年第5期392-395,共4页Chinese Journal of Internal Medicine

基　　金：全军“十一五”杰出人才基金（06J005）;全军“十一五”计划面上课题项目基金（06MB099）

摘　　要：目的研究自体骨髓间充质干细胞（MSCs）与造血干细胞共移植治疗恶性血液病的安全性和可行性，及其对移植后造血重建的影响。方法从无骨髓浸润的恶性血液病患者本人骨髓中分离、培养间充质干细胞，经放化疗等预处理后，与造血干细胞共移植治疗恶性血液病患者5例，其中恶性淋巴瘤4例，粒细胞肉瘤1例，并观察其对移植后造血重建的影响。结果MSCs联合造血干细胞共移植治疗恶性血液病患者5例，MSCs输注过程顺利，未见明显不良反应。移植后造血恢复过程中，中性粒细胞≥0．5×10^9／L的中位时间为9．4（8～11）d、血小板≥20×10^9／L的中位时间为12．2（10～14）d。结论MSCs联合造血干细胞共移植治疗恶性血液病安全性好，未见明显副作用。结果提示输注MSCs可促进造血恢复，但其远期疗效仍有待于进一步观察。Objective To explore the feasibility and safety of cotransplantation of autologous bone marrow-derived mesenchymal stern cells （MSCs） and peripheral blood stem cells in hematological malignant diseases and to observe its effect on hematopoietic reconstruction after cotransplantation. Methods Adult human MSCs were isolated from the healthy bone marrow of the patient himself with Percoll （ 1. 073 g/ml） and cultured in Dulbecco＇s modified Eagle＇s medium with low glucose containing 10% AB type human serum. After conditioning regimen of high-dose chemotherapy and radiotherapy, cotransplantation of autologous bone marrow-derived MSCs and peripheral blood stem cells was done in five patients with hematological malignant diseases. Results The process of the infusion was safe and there were no adverse reactions or other toxicities related to the infustion of MSCs. The median time to achieve neutrophil counts greater than 0. 5 × 10^9/L was 9. 4 days （ ranging from 8 to 11 days ） after cotransplantation and platelet counts greater than 20 ×10^9/L 12. 2 days （ranging from 10 to 14 days）. Conclusion Cotransplantation of autologous bone marrow-derived MSCs and peripheral blood stem cells in hematological malignant diseases is feasible and safe. The rapid hematopoietic reconstruction after cotransplantation shows that MSCs have an effect on hematopoiesis, but the mechanism is still to be investigated.

关 键 词：骨髓 间质干细胞 造血干细胞 

分 类 号：R686[医药卫生—骨科学]