自体或异体间充质干细胞移植对造血重建的影响

目的 初步探讨自体或异体间充质干细胞(MSC)移植对造血重建的影响.方法 采用含血清培养体系培养扩增自体或供者骨髓以及来自胚胎的MSC,例1为系统性红斑狼疮(SLE);例2为非霍奇金淋巴瘤(NHL),患者在造血干细胞移植(HSCT)前先输注自体MSC,然后进行自体HSCT;例3为阵发性睡眠性血红蛋白尿(PNH),在HSCT前先输注供者MSC,然后进行同基因异体HSCT;例4为慢性粒细胞白血病(CML),行异基因HSCT;例5为淋巴瘤行自体HSCT,在移植后造血恢复缓慢(分别为+129天,+78天)移植来自胚胎的MSC.结果 例1、例2和例3患者MSC和HSCT联合无明显不良反应.中性粒细胞≥0.5×109/L和血小板≥20×109/L的时间分别为移植后1、10、10和1、8、33 d.粒细胞缺乏时间分别为0、7、12 d;输注来自胚胎MSC的患者(例4、例5),1个月内造血仍无恢复,MSC移植失败.结论 MSC移植时机掌握很重要,与HSCT同时进行,可以促进造血重建,而在移植后一些造血重建缓慢的患者再进行MSC移植的疗效还有待进一步研究.

Abstract：

Objective To investigate the impact of auto and allogenic mesenchymal stem cells (MSC) transplantation on hematopoietic reconstitution. Methods MSC from auto, donor bone marrow or embryonic tissue were cultured and expanded in vitro in the serum culture system. Five patients received hematopoietic stem cell transplantation (HSCT) were investigated. Case 1 of systemic lupus erythematosus and Case 2 of non-hodgkin' s lymphoma (NHL) received auto MSC transplant before auto-HSCT. Case 3 of paroxysmal nocturnal hemoglobinuria received HLA-identical allogenic MSC transplant before HLA-identical allo-HSCT.Case 4 of chronic myelocytic leukemia and Case 5 of NHL had delayed hematopoietic reconstitution (129th and 78th day, respectively) after allo- and auto-HSCT, respectively, and received MSC from embryonic tissue.Results Case 1, 2 and 3 had no manifested side effects after MSC transplantation combined with HSCT.Neutrophil count of case 1, 2, and 3 were over 0.5 ×109/L at 1st, 10th and 10th day, respectively, platelet count were over 20 ×109/L at 1st, 8th and 33th day, respectively, and agranulocytosis at Ost, 7th and 12th day, respectively. The treatment of embryonic tissue MSC transplant was confirmed to fail for Case 4 and 5.Conclusion The time of MSC transplant has a great impact on hematopoietic reconstitution. MSC transplantation and HSCT performed simultaneously can improve hematopoietic reconstitution. However, the impact of MSC on patients with delayed hematopoietic reconstitution after HSCT needs further study.

Clinical research on influence of auto or allo-mesenchymal stem cells transplantation on hematopoietic recovery

Objective To investigate the impact of auto and allogenic mesenchymal stem cells (MSC) transplantation on hematopoietic reconstitution. Methods MSC from auto, donor bone marrow or embryonic tissue were cultured and expanded in vitro in the serum culture system. Five patients received hematopoietic stem cell transplantation (HSCT) were investigated. Case 1 of systemic lupus erythematosus and Case 2 of non-hodgkin' s lymphoma (NHL) received auto MSC transplant before auto-HSCT. Case 3 of paroxysmal nocturnal hemoglobinuria received HLA-identical allogenic MSC transplant before HLA-identical allo-HSCT.Case 4 of chronic myelocytic leukemia and Case 5 of NHL had delayed hematopoietic reconstitution (129th and 78th day, respectively) after allo- and auto-HSCT, respectively, and received MSC from embryonic tissue.Results Case 1, 2 and 3 had no manifested side effects after MSC transplantation combined with HSCT.Neutrophil count of case 1, 2, and 3 were over 0.5 ×109/L at 1st, 10th and 10th day, respectively, platelet count were over 20 ×109/L at 1st, 8th and 33th day, respectively, and agranulocytosis at Ost, 7th and 12th day, respectively. The treatment of embryonic tissue MSC transplant was confirmed to fail for Case 4 and 5.Conclusion The time of MSC transplant has a great impact on hematopoietic reconstitution. MSC transplantation and HSCT performed simultaneously can improve hematopoietic reconstitution. However, the impact of MSC on patients with delayed hematopoietic reconstitution after HSCT needs further study.