异基因造血干细胞移植治疗儿童恶性血液病15例临床分析  

Clinical analysis of allogeneic hematopoietic stem cells transplantation for treatment of 15 children with malignant hematological diseases

作　　者：王娴静[1] 董秀娟[1] 陈蕾[1] 马红霞[1] 焦雪丽[1] 吴书一[1] 刘文刚[1] 赵晓武[1] 

机构地区：[1]郑州市第三人民医院血液科,450000

出　　处：《白血病．淋巴瘤》2014年第12期717-720,共4页Journal of Leukemia & Lymphoma

摘　　要：目的 观察异基因造血干细胞移植（allo-HSCT）治疗儿童恶性血液病的疗效和相关并发症,探讨allo-HSCT治疗儿童恶性血液病的适应证.方法 回顾性分析15例接受allo-HSCT治疗的儿童恶性血液病患者的临床资料,其中13例为急性白血病,1例为慢性粒细胞白血病（加速期）,1例为骨髓增生异常综合征（MDS-REBT）;8例为亲缘供者,7例为非亲缘供者;11例行外周血造血干细胞移植治疗,4例行脐血造血干细胞移植治疗;6例为HLA配型全相合,9例为HLA配型不全相合.结果 15例患儿中生存7例,生存期为5个月～6年;5例因复发或重症感染放弃治疗;3例死亡.6例发生急性移植物抗宿主病（GVHD）,包括Ⅰ度3例,Ⅱ、Ⅲ、Ⅳ度各1例,其中发生Ⅳ度急性GVHD患儿死亡.2例发生广泛性慢性GVHD,其中1例死亡,另1例生活质量严重受影响.结论 allo-HSCT是治疗儿童恶性血液病的重要方法,其并发症多、风险大,在防治并发症的同时,应严格把握allo-HSCT治疗儿童恶性血液病的适应证.Objective To observe the therapeutic efficiency and associated complications of allogeneic hematopoietic stem cells transplantation （allo-HSCT） for treatment of children with malignant hematological disease.Methods Fifteen children with malignant hematological disease were subjected to allo-HSCT from Jan 2007 to Jan 2013.Among those 15 patients,13 cases were diagnosed as acute leukemia （AL）,1 case as chronic myeloid leukemia （CML）,and 1 case as myelodysplastic syndrome （MDS-RAEB）.The clinical characters of all cases after transplantation were analyzed retrospectively.Results Seven cases survived from 5 months to 6 years after transplantation.Five cases abandoned treatment because of relapse or severe infections.Three cases developed grade Ⅰ acute graft-versus-host disease （aGVHD）,three cases developed grade Ⅱ,Ⅲ and Ⅳ aGVHD respectively,and one case died of Ⅳ aGVHD.Two patients experienced extensive chronic graft-versus-host disease （cGVHD）,in whom one died of cGVHD,the other suffered with poor quality of life.Conclusions Allo-HSCT is an efficient operation for the treatment of children with hematologic malignancies.Reduction of complications associated with allo-HSCT is the first issue needs to be overcome,meanwhile,it is also important to understand the indications of children allo-HSCT.

关 键 词：异基因造血干细胞移植 恶性血液病 儿童 并发症 适应证 

分 类 号：R733.7[医药卫生—肿瘤]