脐带间充质干细胞治疗造血干细胞移植后出血性膀胱炎5例临床观察  

Observation on Umbilical Cord-mesenchymal Stem Cell for the Treatment of 5 Cases with Hemorrhagic Cystitis after Hematopoietic Stem Cell Transplantation

作　　者：贾锐[1] 杨晓凤[1] 陆岩[1] 吕乃武[1] 刘福庆[1] 张轶斌[1] 王红梅[1] 周金旭[1] 刘心平[1] 吕欣[1] 

机构地区：[1]中国人民解放军第463医院细胞治疗中心,辽宁沈阳110042

出　　处：《医学临床研究》2011年第10期1901-1904,共4页Journal of Clinical Research

摘　　要：[目的]探讨脐带间充质干细胞在异基因造血干细胞移植术后出血性膀胱炎治疗中的应用价值.[方法]22例进行性肌营养不良症（Duchenne muscular dystrophy,DMD）男性儿童应用BuCy＋Flu方案预处理后行异基因造血干细胞移植术,预处理期间给予美斯钠、水化、碱化等治疗常规预防出血性膀胱炎.其中5例患者在移植-2～＋50天出现（Ⅲ～Ⅳ度） 出血性膀胱炎,其中2例为早发性,3例为迟发性,5例均为持续性,且3例伴随Ⅱ～Ⅳ度急性移植物抗宿主病,1例伴随巨细胞病毒感染.在常规治疗基础上,联合应用脐带间充质干细胞静脉输注,每周1次.5例患者共进行12次输注（平均2.4次/人）,单次输注细胞数量为0.61～3.83×106/kg（中位数量1.44±0.83×106/kg）.[结果]5例患者全部治愈,有效率达100%,尿路刺激症状消失时间为治疗后8～30 d（平均16.8 d）,肉眼血尿、镜下血尿消失时间分别为治疗后20.8（12～35）d、25.8（16～40）d,无不良反应.随访109（60～120）d,无一例膀胱炎复发.[结论]脐带间充质干细胞治疗造血干细胞移植术后重度出血性膀胱炎疗效好。[Objective] To explore the value of umbilical cord-mesenchymal stem cells（UC-MSCs） for the treatment of hemorrhagic cystitis（HC） after allogeneic hematopoietic stem cell transplantation（allo-HSCT）. [Methods] Twenty two boys with Duchenne muscular dystrophy（DMD） received allo-HSCT after the pretreatment of BuCy＋ Flu scheme. During the pretreatment of BuCy＋Flu scheme, the conventional therapy such as Mesna, hydration and alkalization of urine for the prevention of HC was given. HC（Ⅲ-Ⅳ degree） occurred in 5 cases at -2- ＋50 days of transplantation in which 2 cases were early onset and 3 cases were late onset. All of the 5 cases were persistent in which 3 cases were complicated by acute graft versus host disease（aGVHD） with Ⅱ-Ⅳ degree and one case was complicated with cytomegalovirus（CMV） infection. Based on the conventional therapy of HC, UC-MSCs was intravenously injected once a week for the total of 12 times（mean 2.4 times per patient）. The mean number of the cells injected every time was 1.44±0.83× 10^6/kg（0.61-3.83× 10^6/kg）. [Results] All of the 5 patients were cured. The effective rate reached 100 %. The urinary irritation symptoms disappeared within 8-33 days（mean 16.8 days） after treatment. Gross hematuria disappeared within 7-47 days（mean 20. 8 days）. Microscopic hematuria disappeared in 15-57 days（mean 25.8 days）. All patients were followed up for 60-120 days（mean 109 days）. No adverse reaction occurred. None of the patients recurred. [Conclusion] UC-MSCs for the treatment of severe HC after HSCT has good effect without adverse reaction.

关 键 词：膀胱炎/治疗 造血干细胞移植 

分 类 号：R694.3[医药卫生—泌尿科学]