供者细胞回输数量对单倍型造血干细胞移植后急性移植物抗宿主病的影响

目的 评价单倍型造血干细胞移植(Haplo-HSCT)后重度急性移植物抗宿主病(aGVHD)发生率与回输细胞数量的关系.方法 回顾性分析2009年1月至2013年12月进行Haplo-HSCT的68例患者临床资料,分析移植前后各因素与移植后Ⅲ~Ⅳ度aGVHD发生率的关系.结果 68例患者中,男性42例,女性26例,HLA配型为5/10至9/10相合,其中父亲供者19例,母亲供者24例,兄弟姐妹供者16例,子女供者9例.未出现Ⅲ~Ⅳ度aGVHD患者51例,其中男性32例,女性19例,中位年龄20岁(5~55岁);出现Ⅲ~Ⅳ度aGVHD患者17例,其中男性10例,女性7例,中位年龄23岁(5~54岁).两组回输的单个核细胞(MNC)计数、CD34+细胞数以及移植后白细胞计数和血小板计数恢复快慢程度差异均无统计学意义(均P>0.05),以上4个因素中MNC与CD34+细胞数量、白细胞植活时间存在相关性(均P<0.05),而CD34+细胞数量及白细胞植活时间均与血小板植活时间有相关性(均P<0.05).结论 移植后发生Ⅲ~Ⅳ度aGVHD与回输的MNC及CD34+细胞数量无关.

Affects of the amount of grafted cells on acute graft versus host disease after haploid hematopoietic stem cell transplantation

Objective To evaluate the relationship between the amount of grafted cells and the incidence of acute graft versus host disease (aGVHD) after haploid hematopoietic stem cell transplantation (haplo-HSCT). Methods Data of 68 patients who underwent haplo-HSCT from Jan 2009 to Dec 2013 were analyzed retrospectively. Influences of different factors on the incidence of Ⅲ-Ⅳ degree of aGVHD after HSCT were evaluated. Results 68 patients including 42 males and 26 females were 5/10-9/10 HLA match with 19 father donors, 24 mother donors, 16 sibling donors and 9 children donors. 51 patients not suffered Ⅲ-Ⅳdegree of aGVHD included 32 males and 19 females with the mean age of 20 years old (5-55 years old). 17 patients sufferedⅢ-Ⅳdegree of aGVHD including 10 males and 7 females with the mean age of 23 years old (5-54 years old). There were no significant differences in the amount of the grafted mononuclear cells (MNC) and CD34+cells, and the white blood cell counts (WBC) and platelet count (Plt) recovered time between two groups (P>0.05). However, MNC number was related to CD34+cell number (P<0.05) and WBC recover time (P<0.05), and the CD34+cells number was related to WBC and Plt recover time (P< 0.05). Conclusion The incidence of Ⅲ-Ⅳ degree of aGVHD is unrelated to the amount of grafted MNC, and CD34+cells.