儿童第二次非血缘供者造血干细胞移植2例

目的探索非血缘造血干细胞移植后复发病例进行第二次移植的可行性。方法患幼年型慢性粒单细胞性白血病(JMML)及重型β-地中海贫血的两例患儿接受非血缘供者造血干细胞移植后分别于移植后的10个月和1个月后原疾病复发,前者给予福达华加环磷酰胺预处理后输注原供者干细胞,降低预防移植物抗宿主病强度;后者给予含TBI预处理,移植另一非血缘供者外周血干细胞。结果两例患者第二次移植后均获得稳定植入,JMML患者并发急慢性移植物抗宿主病,完全缓解至+24月;地中海贫血患者已完全脱离输血状态至+23月。结论对于非血缘造血干细胞移植后复发的患儿,第二次非血缘供者造血干细胞移植是可行的。

Second unrelated hematopoietic stem cells transplantation for two children

Objective To explore the feasibility for children who relapsed after undergoing unrelated hematopoietic, stem cells transplantation(HSCT). Patients and methods One child with juvenile myelomonocytic leukemia (JMML) and one child with β-thalassemia major underwent unrelated HSCT, but relapsed after 10 months and I month respectively. The JMML patient received the same donor’s PBSC for second transplantation with conditioning of fludarabine and cyclophosformade, and reduced intension of prophylaxis of GVHD. The thalassemic patient received another unrelated donor’s PBSC for second transplantation after conditioning which including TBI. Results Two patients all got stable engraftment after second HSCT. The JMML patient suffered acute and chronic graft versus host disease and has been complete remission to +24 months. The thalassemic patient has been independent on blood infusion to +23 months. Conclusion Second unrelated HSCT is feasible in relapsed children who had undergone unrelated HSCT.