单倍型异基因造血干细胞移植后大剂量环磷酰胺诱导免疫耐受治疗儿童重型再生障碍性贫血.doc.docVIP

单倍型异基因造血干细胞移植后大剂量环磷酰胺诱导免疫耐受 治疗儿童重型再生障碍性贫血 郭 智1，童 春1，2，刘晓东1，杨 凯1，何学鹏1，张 媛1，陈 鹏1，楼金星1，陈惠仁1(1解放军北京军区总医院血液科，北京市 100700；2安徽医科大学附属北京军区总医院临床医学院，北京市 100700) 引用本文：郭智，童春，刘晓东，杨凯，何学鹏，张媛，陈鹏，楼金星，陈惠仁. 单倍型异基因造血干细胞移植后大剂量环磷酰胺诱导免疫耐受治疗儿童重型再生障碍性贫血[J].中国组织工程研究，2016，20(32):4818-4824. DOI: 10.3969/j.issn.2095-4344.2016.32.016 ORCID: 0000-0002-1164-9978(郭智) 文章快速阅读： 文题释义： 移植失败：移植后28 d内外周血中性粒细胞绝对值没有达到0.5×109 L-1以上；初次植活并在移植后100 d内中性粒细胞绝对值又下降到0.5×109 L1以下，血小板 20×109 L1，至少1周以上。原因可能系HLA不全相合移植，相合非亲缘移植，T淋巴细胞清除或移植前输血使受者致敏，供者骨髓中造血干细胞质量欠佳或祖细胞亚群不足，脐血移植治疗重型再生障碍性贫血 基金资助： 国家自然科学基金：DKK-1在间充质干细胞诱导免疫耐受机制中的调控作用；北京市首都临床特色课题：诱导耐受新方法造血干细胞移植治疗重型再生障碍性贫血的临床研究 High-dose cyclophosphamide-induced immunogenic tolerance following haploidentical allogeneic hematopoietic stem cell transplantation in severe aplastic anemia children Guo Zhi1, Tong Chun1, 2, Liu Xiao-dong1, Yang Kai1, He Xue-peng1, Zhang Yuan1, Chen Peng1, Lou Jin-xing1, Chen Hui-ren1 (1Department of Hematology, General Hospital of Beijing Military Area, Beijing 100700, China; 2Clinical Medical College of General Hospital of Beijing Military Area, Anhui Medical University, Beijing 100700, China) Abstract BACKGROUND: High-dose cyclophosphamide (CTX)-induced immunogenic tolerance following haploidentical allogeneic hematopoietic stem cell transplantation (allo-HSCT) is developed to optimize the treatment of childhood severe aplastic anemia (SAA) using haplotype allo-HSCT, providing a theoretical basis for the clinical application. OBJECTIVE: To investigate the clinical efficacy and safety of the use of high-dose CTX following haploidentical allo-HSCT in SAA children. METHODS: Clinical data from 10 children with SAA undergoing haploidentical allo-HSCT at the Department of Hematology, General Hospital of Beijing Military Area from January 2013 to January 2015 were retrospectively analyzed. Pretreatment was CTX, fludarabine, Busulfex combined with anti-human lymphocyte immune globulin used for 2 consecutive days, and then 3 days after