本文選題：臍帶血移植 + 血液病�。� 參考：《臨床兒科雜志》2017年10期

【摘要】：目的觀察臍帶血治療兒童血液病的治療效果及預(yù)后。方法回顧分析2011年1月至2016年6月期間51例接受臍帶血移植患兒的臨床資料。結(jié)果 51例患兒中,男34例、女17例,中位年齡62個(gè)月;惡性血液病32例,非惡性血液病19例。2例在粒細(xì)胞未重建時(shí)死亡,4例發(fā)生原發(fā)性植入失敗,45例植入成功。粒細(xì)胞植入中位時(shí)間16天,血小板植入中位時(shí)間23天。圍植入綜合征發(fā)生率46.94%,圍植入綜合征患兒移植后100天內(nèi)以及長(zhǎng)期總生存率(OS)分別為(73.9±9.2)%和(50.2±11.7)%,均低于無(wú)圍植入綜合征患兒的OS 100%,差異有統(tǒng)計(jì)學(xué)意義(P0.01)。急性移植物抗宿主病(aGVHD)發(fā)生率為55.10%,其中II~Ⅲ度aGVHD占28.57%,Ⅳ度aGVHD 26.53%;Ⅳ度aGVHD患兒移植100天內(nèi)OS為(61.5±13.5)%;Ⅲ和Ⅳ度aGVHD患兒的長(zhǎng)期OS分別為(75.0±21.7)%和(44.9±14.1)%,未發(fā)生aGVHD患兒的長(zhǎng)期OS為(90.2±6.6)%,差異有統(tǒng)計(jì)學(xué)意義(χ2=14.35,P=0.002)。慢性GVHD(c GVHD)發(fā)生率為28.57%;c GVHD患兒的長(zhǎng)期OS為(72.7±13.4)%,無(wú)c GVHD患兒100%存活。臍血移植后100天內(nèi)OS(86.0±4.9)%;臍血移植長(zhǎng)期OS(77.9±6.3)%,其中惡性血液病為(76.6±7.8)%,非惡性血液病為(79.5±11.3)%。惡性血液病中急性淋巴細(xì)胞白血病(ALL)的OS為(87.5±11.7)%,急性髓細(xì)胞白血病(AML)為(76.7±10.3)%,骨髓增生異常綜合征(MDS)為(33.3±27.2)%。結(jié)論臍帶血移植是治療兒童血液病的有效手段,重視圍植入綜合征的處理,積極防治Ⅲ/Ⅳ度aGVHD和c GVHD是提高臍帶血移植療效的重要策略。
[Abstract]:Objective to observe the therapeutic effect and prognosis of umbilical cord blood in children with hematopathy. Methods the clinical data of 51 children with umbilical cord blood transplantation from January 2011 to June 2016 were retrospectively analyzed. Results among the 51 children, 34 were male, 17 were female, the median age was 62 months, 32 were malignant hematopathy and 19 were non-malignant hematopathy. 4 patients died of failure of primary implantation without granulocyte reconstruction. The median time of granulocyte implantation was 16 days and that of platelet implantation was 23 days. The incidence of periimplantation syndrome was 46.94. The overall survival rate within 100 days after transplantation and the long-term overall survival rate were 73.9 鹵9.2% and 50.2 鹵11.7%, respectively, which were lower than those in the patients without peri-implantation syndrome (P 0.01). The incidence of acute graft-versus-host disease (aGVHD) was 55.100.The incidence of grade II- 鈪，

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