免疫抑制联合脐带血输注治疗重型再生障碍性贫血的疗效

目的 探讨免疫抑制联合脐带血输注治疗重型再生障碍性贫血（SAA）的临床疗效。方法 选择2011年10月至2016年7月安徽医科大学第一附属医院收治的16例SAA患者，回顾分析患者的临床资料，并随访疗效。结果 中位随访时间37（2~51）个月，总有效率为81.3%，2年无病生存率为81.3%，总生存率为87.5%。所有患者中性粒细胞>0.5×10⁹/L的中位时间为治疗后14 d，13例有效患者脱离输血时间为治疗后25～180 d。监测短串联重复序列聚合酶链反应，1例患者治疗后56天脐血100%嵌合，第125天血常规恢复正常；1例患者治疗后第7天检测脐血100%嵌合，第25天转为受者100%嵌合，余14例患者脐带血均未植入。结论 强化免疫抑制联合脐带血输注治疗成人SAA，并发症较少，疗效显著。

Efficacy of immunosuppressive therapy combined with umbilical cord blood infusion in treatment of patients with severe aplastic anemia

Objective To investigate the effect of increased immunosuppressive treatment combined with unrelated umbilical cord blood infusion in patients with severe aplastic anemia. Method A total of 16 patients with severe aplastic anemia who received the therapy of increased immunosuppressive(IST) regimen plus umbilical cord blood (UCB) infusion at our department were enrolled in the study.Results The median follow-up was 37 months.The total response rate was 81.3%. The event-free survival of two years was 81.3% and total survival rate was 87.5%. The median time of neutrophil (count>0.5×10⁹/L) was 14d.Unexpected umbilical cord blood stem cell engraftment occurred in two patients, among whom one had 100% chimerism of umbilical cord 56 days after treatment and returned to normal in routine blood test on 125 day, the other had 100% chimerism of umbilical cord 7 days after treatment and returned to recipient 100% chimerism.The others showed no signs of donor engraftment in chimerism analysis.Conclusion Intensive immunosuppressive therapy combined with umbilical cord blood infusion is effective for severe aplastic anemia.