父母供子女单倍型造血干细胞移植治疗恶性血液病

背景：单倍型造血干细胞移植是治疗恶性血液病的一种有效方法,合适的供者及快速查找到合适的供者有助于提高移植的成功率。目的：比较父母供子女单倍型造血干细胞移植治疗恶性血液病的临床疗效。方法：对郑州大学第一附属医院92例恶性血液病患者行父母为供者的单倍型造血干细胞移植治疗,分为父供子移植、父供女移植、母供子移植、母供女移植4组,对比4组患者移植物抗宿主病的发生率、复发率、2年无病生存率及总生存率等。结果与结论：92例患者均完全植入并获得造血重建,4组急性移植物抗宿主病发生率、慢性移植物抗宿主病发生率和复发率差异无显著性意义（P〉0.05）。但4组Ⅲ、Ⅳ度急性移植物抗宿主病发生率、2年无病生存率、2年总生存率差异有显著性意义（P〈0.05）。其中父供子移植组、母供女移植组的Ⅲ、Ⅳ度急性移植物抗宿主病发生率低于父供女移植组和母供子移植组;同时父供子移植组和母供女移植组的2年无病生存率、2年总生存率高于父供女移植组和母供子移植组。可见父母供子女单倍型造血干细胞移植是安全可行的,供受者性别相同比供受者性别不同的疗效好。

Parental haploidentical hematopoietic stem cell transplantation for treatment of hematologic malignancies

BACKGROUND： The haploidentical hematopoietic stem cell transplantation is an effective treatment method of hematologic malignancies. It is very useful for increasing the successful rate of stem cell transplantation to find an appropriate donor rapidly. OBJECTIVE： To compare the clinical effect of parental haploidentical hematopoietic stem cell transplantation for treatment of hematologic malignancies. METHODS： Ninety-two patients with hematologic malignancies who underwent parental haploidenticalhematopoietic stem cell transplantation were divided into four groups, including father-to-son transplantation group, father-to-daughter transplantation group, mother-to-son transplantation group and mother-to-daughter transplantation group. The incidence of graft versus host disease, recurrence rate, and 2-year disease-free survival and overall survival rate were compared between groups. RESULTS AND CONCLUSION： Engraftment was successful in a total of 92 patients. There were no significant differences of incidence of acute graft versus host disease, chronic graft versus host disease and recurrence rate among four groups （P＆gt;0.05）. Significant difference was observed in the occurrence of Ⅲ-Ⅳ acute graft versus host disease, 2-year disease-free survival rate and 2-year overall survival rate among four groups （P＆lt;0.05）. The incidence of Ⅲ-Ⅳ acute graft versus host disease in father-to-son transplantation group and mother-to-daughter transplantation group was significantly lower than that in father-to-daughter transplantation group and mother-to-son transplantation group; 2-year disease-free survival rate and 2-year overall survival rate in the father-to-son transplantation group and mother-to-daughter transplantation group were higher than those in the father-to-daughter transplantation group and mother-to-son transplantation group. Parental haploidentical hematopoietic stem cell transplantation is safe and feasible, and the same gender of patients and donors have better effect than the different genders of patients and donors.