HLA部分相合父母供髓骨髓移植二次治疗重型地中海贫血

目的探讨同胞脐血植入失败的重型β地中海贫血患者,应用HLA部分相合父母亲骨髓进行第二次移植的效果。方法两例分别应用同胞HLA2个位点不合和全相合脐血移植的重型β地中海贫血患者,首次移植后均发生植入失败,前者表现为重型再生障碍性贫血,后者自体造血恢复。分别于首次移植13、12个月后,应用HLA部分相合的父亲、母亲骨髓进行第二次移植,观察临床疗效。结果一例重型再生障碍性贫血患者,应用HLA4个位点相合的父亲骨髓进行第二次移植,再次发生植入失败;另一例自体恢复者,应用HLA5个位点相合的母亲骨髓进行第二次移植获成功植入,现已脱离输血20个月。结论在选择合适的移植时机和预处理方案的前提下,父母供髓的二次移植对植入失败的重型β地中海贫血可起到有效的治疗作用。

Second transplantation using allogeneic bone marrow from parents for beta-thalassaemia major patients after graft failure

Objective To evaluate the effect of second bone marrow transplantation(BMT) from parental donor for beta-thalassaemia major patients who got graft failure after the first sibling cord blood transplantation.Methods Two beta-thalassaemia major patients with graft failure (one for bone marrow aplasia and the other for autologous recovery in BMT1) received a second BMT (BMT2) after first sibling cord blood transplantation.The inter-transplant interval were 13 months and 12 months respectively.For BMT2,the first patient had paternal donation with 4 HLA matches and the other had maternal donation with 5 HLA matches.Results The first patient failed to engraft again;the other patient acquired full donor hematopoietic reconstruction and remained transfusion independent for 20 montis after second transplant.Conclusion This study shows that BMT2 for graft failure is an effective treatment and parental sources of the stem cells are feasible.