脐带间充质干细胞治疗儿童异基因造血干细胞移植后急性移植物抗宿主病疗效观察  

Curative Effect of Human Umbilical Cord Mesenchymal Stem Cells for Treatment of Acute Graft-versus-host Disease of Children after Allo-HSCT

作　　者：乔淑敏[1,3] 陈广华[1] 王易[2] 胡绍燕[2] 孙绪丁[3] 吴德沛[1] 

机构地区：[1]苏州大学附属第一医院,江苏省血液研究所,卫生部血栓与止血重点实验室,江苏苏州215006 [2]苏州大学附属儿童医院血液科,江苏苏州215002 [3]济宁市第一人民医院儿科,山东济宁272000

出　　处：《中国实验血液学杂志》2013年第3期716-720,共5页Journal of Experimental Hematology

基　　金：江苏省临床医学研究中心项目(编号BL2012005);江苏省卫生厅面上项目(H201212);江苏省临床医学中心血液病学开放课题(编号KF200943)

摘　　要：本研究观察人脐带间充质干细胞(MSC)治疗儿童急性移植物抗宿主病的疗效和安全性。用胶原酶消化法分离培养人脐带间充质干细胞,进行传代培养、扩增,培养至第3-5代用于临床治疗;5例急性白血病患儿经化疗达完全缓解。2例行亲缘HLA3/6位点相合的骨髓造血干细胞移植,1例行同胞HLA全相合骨髓与外周血造血干细胞联合移植,1例行无血缘关系HLA4/6位点相合双份脐血造血干细胞移植,1例行无血缘关系HLA5/6位点相合单份脐血造血干细胞移植。患儿发生Ⅲ-Ⅳ度急性移植物抗宿主病(aGVHD),接受二线免疫抑制治疗无效后,行0.5×106/kg受者体重MSC治疗。结果表明,5例急性白血病患儿均获造血重建,并发生皮肤、肝脏和胃肠道Ⅲ-Ⅳ度aGVHD,经二线免疫抑制治疗无效,输注人脐带间充质干细胞治疗后,皮疹消退,肝功能恢复正常,胃肠道症状好转。患儿均未发生输注相关不良反应。目前患儿均无原发病的复发,均处于无病生存状态。结论:异基因造血干细胞移植是治疗儿童急性白血病的有效方法,脐带间充质干细胞治疗儿童急性移植物抗宿主病是安全有效的。This study was aimed to investigate the curative effect and safety of human umbilical cord mesenchymal stem cells （hUCMSC） to treat acute graft-versus-host disease （aGVHD） of children after hematopoietic stem cell transplantation（HSCT）. HUCMSC were isolated and cultured by collagenase digestion and passage culture. The 3rd to the 5th passage of hUCMSC were used for clinical treatment. Five cases of children acute leukemia achieved complete remission after chemotherapy. Two cases received HLA 3/6 loci matched haploidenticai bone marrow HSCT. One case received HLA-matched sibling bone marrow and peripheral blood HSCT. One case received unrelated HLA 4/6 loci matched umbilical cord blood HSCT. One case received unrelated HLA 5/6 loci matched umbilical cord blood HSCT. The children received e therapy after Ⅲ - IV aGVHD occurring. They received 0.5 x 10^6/kg hUCM- SC infusion when conventional therapy was ineffective. The results showed that 5 cases of children acute leukemia a- chieved hematopoietic reconstitution and developed the Ⅲ - 1V grade aGVHD. The five cases of children were infused with hUCMSC. The rash subsided, the liver function was normalized and the gastrointestinal symptoms were improved. The infusion-related adverse reaction did not happen. At present, the 5 children are in remission. It is concluded that allogeneic HSCT is an effective therapeutic method for children with acute leukemia. HUCMSC infusion can be safely and effectivelv used for the treatment of refractory aGVHD.

关 键 词：脐带间充质干细胞 异基因造血干细胞移植 急性移植物抗宿主病 

分 类 号：R457.7[医药卫生—治疗学]