两种第三方细胞联合单倍体相合造血干细胞移植治疗慢性再生障碍性贫血1例

本研究观察脐带间充质千细胞（mesenchymalstemcell，MSC）和单倍体相合脐血细胞作为第三方细胞联合单倍体相合异基因造血干细胞移植治疗慢性再生障碍性贫血的安全性和疗效。患者为女性，12岁，诊断为慢性再生障碍性贫血11年，供者为其母亲，单倍体相合，移植物为经粒细胞集落刺激因子（granulocytecolony-stimulatingfactor，G-CSF）动员的骨髓以及外周血追血干细胞。同时加入分离、扩增的hUC-MSC及患者胞弟HLA单倍体相合脐血细胞作为第三方细胞联合移植。移植物抗宿主病（graft-versus-hostdisease，GVHD）预防采用环孢菌素A＋ATG＋霉酚酸酯＋短程甲氨喋呤＋CD25单克隆抗体。结果表明：输注供者的MNC总数和CD34细胞数分别为7．92×10^8／L和3．78×10^6／L，中性粒细胞大于0．5×10^9／L和血小板大于20×10^9／L的时间分别为12d和14d，35d嵌合体94％，无严重并发症出现。结论：从初步结果看来，联合两种第三方细胞的单倍体相合异基因造血干细胞移植治疗CAA安全、疗效令人满意。

Transplantation of Haploidentical-hematopoietic Stem Cells Combined with Two Kind of Third Part Cells for Chronic Aplastic Anemia.One Case Report

This study was purposed to investigate the safety and effectivity of haploidentical stem cell transplantation for chronic aplastic anemia（CAA） by using two kind of third part cells： umbilical cord derived mesenchymal stem cells （hUC-MSC） and haploidentical umbilical cord blood cells. The patient is a girl of 12 year old with CAA for 11 years. The donor was her mother. Graft come from haploidentical hematopoietic bone marrow and peripheral blood mobilized with granulocyte clony-stimulating factor （G-CSF）. The human umbilical cord derived mesenchymal stem cells and the haploidentical umbilical cord blood cells were transfered as third pard of cell. The graft-versus-host disease （GVHD） was prevented with CsA, MTX, ATG, CD25 and mycophenolate mofetial. The results indicated that the infused numbers of MNC and CD34＋ cells of donor were 7. 92 × 10^8/kg and 3.78 × 10^6/kg, respectively. The numbers of neutrophils and platelets were over 0. 5 × 10^9/L and 20× 10^9/L on days 12 and 14, respectively. On day 35 the chimeras accounted for 94%. No serious complications appeared up to now. In couclution, the preliminary results suggest that transplanta-tion of haploidentical hematopoietic stem cells combined with two kind of third part cells is safe and satisfactory.