非清髓异基因造血干细胞移植治疗低增生性MDS1例并文献复习

目的探讨非清髓性异基因外周血造血干细胞移植治疗低增生性骨髓增生异常综合征（MDS）的疗效,观察其植入及并发症的发生情况。方法我院诊断为低增生性MDS患者1例,采用氟达拉滨＋阿糖胞苷＋环磷酰胺的非清髓预处理方案,环孢素A＋甲氨蝶呤＋骁悉预防移植物抗宿主病。结果 STR-PCR证实移植后30d及3个月骨髓植入为完全供者型,移植后3个月发生多发性脑梗塞,6个月出现面部皮疹及口腔溃疡,通过调整免疫抑制剂及输注间充质干细胞（5×10^7/次,2次）后症状明显好转。结论非清髓性异基因外周血造血干细胞移植治疗低增生性MDS获得较好的疗效。

A literature review on non-myeloablative allogeneic hematopoietic stem cell transplantation for hypo-MDS

Objective To explore feasibility and efficacy of non-myeloablative allogeneic hematopoietic stem cell transplantation in the treatment of hypocellular myelodysplastic syndrome（hypo-MDS） and its complications.Methods We developed an effective therapy for hypo-MDS using non-myeloablative allogeneic hematopoietic stem cell transplantation with fludarabine,cytarabine and cyclophosphamide.For the prophylaxis of graft versus host disease（GVHD）,cyclosporine,methotrexate and mycophenolate mofetil capsules were used.Results Complete engraftment was confirmed by STR-PCR.Multiple cerebral infarction and chronic GVHD were observed in 3 and 6 month after transplantation,respectively.A relief in clinical symtoms was seen after treatment with immunosuppressive agents and mesenchyme stem cell infusion.Conclusion Non-myeloablative allogeneic hematopoietic stem cell transplantation is an effective therapy for hypo-MDS.