CAJ | 학술논문

第三方骨髓间充质干细胞治疗异基因造血干细胞移植后继发性植入功能不良的疗效及安全性
제삼방골수간충질간세포치료이기인조혈간세포이식후계발성식입공능불량적료효급안전성
The outcome and safety of mesenchymal stem cells from bone marrow of a third party donor in treatment of secondary poor graft function following allogeneic hematopoietic stem cell transplantation

万方数据

中华血液学杂志中華血液學雜誌 중화혈액학잡지
Chinese Journal of Hematology
2012年 2期 98-102 ,共5页

刘晓丹%范志平%彭延文%黄芬%江千里%张贤%余国攀%赵婕%孙竞%项鹏%刘启发

류효단%범지평%팽연문%황분%강천리%장현%여국반%조첩%손경%항붕%류계발

植入功能不良,继发性%造血干细胞移植%间质干细胞%第三方植入功能不良,繼髮性%造血榦細胞移植%間質榦細胞%第三方
식입공능불량,계발성%조혈간세포이식%간질간세포%제삼방
Poor graft function,secondary%Hematopoietic stem cell transplantation%Mesenchymal stem cells%Third party donor

目的评价第三方骨髓来源的间充质干细胞( MSC)对异基因造血干细胞移植( allo-HSCT)后继发性植入功能不良(PGF)的治疗效果及安全性.方法 2007年4月至2010年9月入组5例allo-HSCT后发生继发性PGF的患者,分别在继发性PGF发生后中位第47(35 ～61)天接受体外扩增的第三方供者骨髓来源的MSC,以1×106细胞/kg的剂量单独治疗,若中性粒细胞绝对值(ANC)和PLT分别未达到＞1.5×109/L和＞50.0×109/L的造血恢复标准则于28 ～ 30 d后接受第2次同等剂量的MSC输注.结果 1例患者接受1次、4例患者接受2次MSC治疗,所有患者ANC和PLT均达到恢复标准,其达到恢复的中位时间在第1次MSC输注后的34(25～49)d与47( 26～54)d.中位随访761 (204～ 1491)d未见不良反应.3例患者分别在MSC治疗后第42、48、108天出现EBV血症,其中2例转化为EBV相关的移植后淋巴细胞增殖性疾病.结论第三方供者骨髓来源MSC对移植后继发性PGF有效,MSC是否会增加EBV感染及EBV相关性淋巴细胞增殖性疾病的发生率有待于进一步研究.
목적 평개제삼방골수래원적간충질간세포( MSC)대이기인조혈간세포이식( allo-HSCT)후계발성식입공능불량(PGF)적치료효과급안전성.방법 2007년4월지2010년9월입조5례allo-HSCT후발생계발성PGF적환자,분별재계발성PGF발생후중위제47(35 ～61)천접수체외확증적제삼방공자골수래원적MSC,이1×106세포/kg적제량단독치료,약중성립세포절대치(ANC)화PLT분별미체도＞1.5×109/L화＞50.0×109/L적조혈회복표준칙우28 ～ 30 d후접수제2차동등제량적MSC수주.결과 1례환자접수1차、4례환자접수2차MSC치료,소유환자ANC화PLT균체도회복표준,기체도회복적중위시간재제1차MSC수주후적34(25～49)d여47( 26～54)d.중위수방761 (204～ 1491)d미견불량반응.3례환자분별재MSC치료후제42、48、108천출현EBV혈증,기중2례전화위EBV상관적이식후림파세포증식성질병.결론 제삼방공자골수래원MSC대이식후계발성PGF유효,MSC시부회증가EBV감염급EBV상관성림파세포증식성질병적발생솔유대우진일보연구.
Objective To evaluate the efficacy and safety of bone marrow-derived mesenchymal stem cells(MSC) from a third party donor for secondary poor graft function(PGF) following allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods Five patients with secondary PGF were treated with MSC at a dose of 1 × 106/kg body weight at a median of 47 days(35 to 61 ) after secondary PGF.MSC were derived from bone marrow(BM) of HLA-disparate third party donors,cultured in vitro and infused without HSC.If absolute neutrophil cell(ANC) and platelet counts(PLT) did not reach the standardization of ＞ 1.5 × 109/L and ＞ 50.0 × 109/L,respectively,within 28 -30 days after the first MSC treatment,a second MSC treatment was required.Results MSC were infused once in one patient and twice in four patients with an interval of 28 to 30 days.All patients obtained ANC and PLT recovery at a median of 34 (25 to 49) days and 47 (26 to 54) days,respectively,without toxic side effects within follow-up periods of median 761 ( 204 - 1491 ) days.Three patients developed Epstein-Barr virus(EBV) reactivation at 42,48,108 days after MSC infusion,respectively and two of the three coverted to posttransplant lymphoproliferative disorders (PTLD).Conclusion MSC from a third party donor are effective to patients with secondary PGF following allo-HSCT,whether it might increase the risk of EBV reactivation and EBV-associated PTLD need further observation.