【摘要】：目的:分析比較單份與雙份非親緣臍血造血干細(xì)胞移植治療血液疾病的臨床效果。方法:回顧性分析2006年至2016年國內(nèi)8家移植中心185例單份臍血干細(xì)胞移植(single-unit umbilical cord blood transplantation,SU-UCBT)與66例雙份臍血干細(xì)胞移植(double-unit umbilical cord blood transplantation,DU-UCBT)病例臨床資料,比較SU-UCBT和DU-UCBT 2種移植方式的植入率、中性粒細(xì)胞和血小板植入時間,惡性和非惡性血液病患者接受SU-UCBT和DU-UCBT后急性移植物抗宿主病(acute graft vs host disease,a GVHD)發(fā)生情況和受者生存率。結(jié)果:SU-UCBT和DU-UCBT受者植入率分別為78.9%和70.7%,其中惡性血液病患者植入率SU-UCBT為89.1%,DU-UCBT為82.5%。非惡性血液病患者SU-UCBT和DU-UCBT植入率分別為64.0%和53.8%,SU-UCBT和DU-UCBT的植入率相似(P0.05)。SU-UCBT和DU-UCBT受者中性粒細(xì)胞植入時間中位數(shù)都為18 d,血小板植入時間中位數(shù)分別為40 d和27 d,無顯著差異(P0.05)。SU-UCBT和DU-UCBT受者Ⅰ、Ⅱ、Ⅲ和Ⅳ度a GVHD發(fā)生率分別為22.6%、22.6%、8.2%、12.3%和21.3%、14.9%、10.6%、10.6%,均無顯著差異(均P0.05)。SU-UCBT和DU-UCBT受者中位生存時間分別為1 460 d(17~2 200 d)和988 d(21~2 200 d),6年累積存活率分別為42.5%和40.4%,無顯著差異(P0.05)。結(jié)論:SU-UCBT和DU-UCBT植入成功患者的中性粒細(xì)胞和血小板植入時間、a GVHD發(fā)生率、存活時間及6年累積存活率均無顯著差異,提示DU-UCBT是安全有效的移植選擇。但仍需完善SU-UCBT和DU-UCBT評價體系及進(jìn)一步探究DU-UCBT的植入機(jī)制,以便指導(dǎo)科學(xué)地選擇UCBT方式。
[Abstract]:Objective: to analyze and compare the clinical effects of single and double unrelated cord blood hematopoietic stem cell transplantation (HSCT) in the treatment of blood diseases. Methods: the clinical data of 18 cases of single umbilical cord blood stem cell transplantation (single-unit umbilical cord blood transplantation,SU-UCBT) and 66 cases of double umbilical cord blood stem cell transplantation (double-unit umbilical cord blood transplantation,DU-UCBT) from 2006 to 2016 were retrospectively analyzed. The implantation rates of SU-UCBT and DU-UCBT, the time of neutrophil and platelet implantation, and the acute graft versus host disease (acute graft vs host disease,) after SU-UCBT and DU-UCBT were compared in patients with malignant and non-malignant hematological diseases. The occurrence of a GVHD) and the survival rate of recipients. Results: the implant rates of SU-UCBT and DU-UCBT recipients were 78.9% and 70.7%, respectively. The implantation rates of SU-UCBT and DU / UCBT in patients with hematological malignancies were 82.1% and 82.5%, respectively. The implantation rates of SU-UCBT and DU-UCBT in patients with non-malignant hematological diseases were 64.0% and 53.8%, respectively, and the implantation rates of SUU UCBT and DU-UCBT were similar (P0.05). The median time of neutrophil implantation in SU-UCBT and DU-UCBT recipients was 18 days. The median time of platelet implantation was 40 d and 27 d, respectively, and there was no significant difference (P0.05). The incidence of 鈪，

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