移植物成分对单倍体相合造血干细胞移植治疗再生障碍性贫血后急性移植物抗宿主病的影响  

Effect of Graft Composition on Acute Graft-Versus-Host Disease in Aplastic Anemia after Haploidentical Hematopoietic Stem Cell Transplantation

作　　者：危薇 丁丽[1] 郑晓丽[1] 韩冬梅[1] 王志东[1] 闫洪敏[1] 王恒湘[1] WEI Wei;DING Li;ZHENG Xiao-Li;HAN Dong-Mei;WANG Zhi-Dong;YANHong-Ming;WANG Heng-Xiang(Department of Hematology,Chinese Air Force General Hospital,Beijing 1012,China)

机构地区：[1]中国人民解放军空军总医院血液科,北京100142

出　　处：《中国实验血液学杂志》2018年第5期1442-1446,共5页Journal of Experimental Hematology

基　　金：首都临床特色应用研究与成果推广(Z151100004015016);首都卫生发展科研专项(首发2014-2-5122)

摘　　要：目的:探讨单倍体相合造血干细胞移植(haploidentical-HSCT,hi-HSCT)治疗再生障碍性贫血(AA)后急性移植物抗宿主病(aGVHD)与移植物成分的关系。方法:回顾性分析57例AA行hi-HSCT的患者,按有无发生Ⅱ-Ⅳ度aGVHD分组,比较2组移植物成分的作用,以分析移植后发生Ⅱ-Ⅳ度aGVHD与移植物成分的关系。结果:57例患者中,14例发生Ⅱ-Ⅳ度aGVHD,43例未发生Ⅱ-Ⅳ度aGVHD。2组的有核细胞计数、CD3^+、CD4^+、CD8^+、NK细胞、NKT细胞、B细胞、Treg细胞数比较后均无统计学差异(P> 0. 05)。发生与未发生Ⅱ-Ⅳ度aGVHD组的CD34^+数分别为为3. 85(1. 73-10. 61)×10~6/kg和6. 31(2. 98-19. 35)×10~6/kg (P <0. 05)。结论:单倍体相合造血干细胞移植治疗再生障碍性贫血后发生Ⅱ-Ⅳ度aGVHD可能与CD34^+有关。Objective:To investigate the relationship between acute graft-versus-host disease and graft composition in patients with aplastic anemia(AA)after haploidentical hematopoietic stem cell transplantation.Methods:Fifty-seven cases of AA after haploidentical hematopoietic stem cell transplantation were retrospectively analyzed.All the patients were divided into 2 groups according to whether presence or absence grade I-V aGVHD,the relationship between aGVHD and graft composition was analyzed by comparing the differences of graft components between the 2 groups.Results:Fourteen out of 57 patients had grade I-V aGVHD and the other 43 did not have grade I-V aGVHD.The mononuclear cells,CD3+,CD4+,CD1+,NK cells,NKT cells,B cells and Treg cells were not significantly different between the 2 groups(P>0.05),the CD34+cell count in the patients with grade I-V aGVHD was 3.15(1.73-10.41)x 104/kg,which was significantly lower than that without grade I-IVaGVHD:4.31(2.91-19.35)xl04y/kg(P<0.05).Conclusions:The incidence of grade I-IV aGVHD may be related with CD34+cell count in AA after haploidentical hematopoietic stem cell transplantation.

关 键 词：再生障碍性贫血 造血干细胞移植 移植物抗宿主病 CD34细胞 

分 类 号：R556.5[医药卫生—血液循环系统疾病] R457.7[医药卫生—内科学]