中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (32): 6073-6076.doi: 10.3969/j.issn.1673-8225.2010.32.041

• 干细胞临床实践 clinical practice of stem cells • 上一篇    

单倍体相合造血干细胞移植治疗髓母细胞瘤1例

胡海燕，郭洪波，吴秉毅，邓   兰，宋朝阳，郭坤元   

  1. 南方医科大学附属珠江医院血液科，广东省广州市 510282
  • 出版日期:2010-08-06 发布日期:2010-08-06
  • 通讯作者: 郭坤元，副教授，南方医科大学附属珠江医院血液科，广东省广州市 510282
  • 作者简介:胡海燕☆，女，1976年生，河南省南阳市人，汉族， 2005年暨南大学毕业，博士， 副研究员，主要从事干细胞分化与发育，肿瘤基因治疗研究。xuri1104@163.com
  • 基金资助:

    国家自然科学基金资助(30800486)项目。

Haploidentical hematopoietic stem cells transplantation for the treatment of medulloblastoma

Hu Hai-yan, Guo Hong-bo, Wu Bing-yi, Deng Lan, Song Chao-yang, Guo Kun-yuan   

  1. Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou  510282, Guangdong Province, China
  • Online:2010-08-06 Published:2010-08-06
  • Contact: Guo Kun-yuan, Associate professor, Department of Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China
  • About author:Hu Hai-yan☆, Doctor, Associate investigator, Department of, Hematology, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, Guangdong Province, China xuri1104@163.com
  • Supported by:

    the National Natural Science Foundation of China, No. 30800486*

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摘要：

背景:目前部分国外报道显示，自体及全相合造血干细胞移植联合化疗用于转移髓母细胞瘤有一定疗效，可延长患者生存期。但尚未见HLA单倍体相合移植治疗髓母细胞瘤的报道。
目的:首次报道应用单倍体相合造血干细胞移植治疗髓母细胞瘤。
方法:对晚期骨转移的髓母细胞瘤患儿进行连续6次无关供者淋巴细胞输注联合低剂量化疗， 3次单倍体相合骨髓移植治疗。
结果与结论:造血干细胞移植后患儿出现皮疹， 伴发热， 腹泻， 为黄褐色水样便， 考虑为移植物抗宿主病， 以甲强龙冲击治疗并用丙种球蛋白增强免疫力， 吗替麦考酚酯、他克莫司抗排斥及口服激素、抗CD25单抗、抗肿瘤坏死因子， 并纠酸、维持水电平衡、支持营养等治疗好转出院， 后因颅内复发死亡。异基因淋巴细胞输注可杀伤肿瘤细胞， 改善患者生存质量， 但对于高肿瘤负荷的患者， 效果有限， 如考虑进行异基因干细胞移植， 应注意免疫抑制剂(如CD25单抗和肿瘤坏死因子a抑制剂)的及时应用。

关键词: 髓母细胞瘤, 淋巴细胞输注, 单倍体, 造血干细胞, 移植, 干细胞移植

Abstract:

BACKGROUND: Some reports demonstrated that, autoallergic or hematopoietic stem cells transplantation combined with chemotherapy received good outcomes in treating medulloblastoma, which can prolong survival time of patients. However, whether haploidentical hematopoietic stem cells transplantation can treat medulloblastoma remains poorly understood.
OBJECTIVE: To firstly report a patient receiving haploidentical hematopoietic stem cells transplantation for treating medulloblastoma.
METHODS: A terminal cancer patient with bone matastases successively received six lymphocyte transfusions from an unrelated donor combined with chemotherapy and three haploidentical hematopoietic stem cell transplantations.
RESULTS AND CONCLUSION: The patient presented erythra, accompanied by fever, diarrhea and yellow brown liquid stools, which was considered as graft versus host disease, and treated by urbason, gammaglobulin, CellCept, Prograf, Basiliximab (anti-CD25 antibody), Infliximab (anti-tumor necrosis factor α antibody), effective antibacterial and supportive treatments. After that, the erythra and diarrhea were remised. But the patient died from cerebral hemorrhage. Allogeneic lymphocyte transfusion can kill or damage tumor cells, improve life quality, but the outcome is restrained for patient with a high tumor burden. Immunosuppressant, such as anti-CD25 antibody and anti-tumor necrosis factor α antibody should be timely used in consideration of allogeneic hematopoietic stem cell transplantation.

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