中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (31): 8116-8121.doi: 10.12307/2026.796

• 造血干细胞 hematopoietic stem cells • 上一篇    下一篇

地中海贫血儿童全相合造血干细胞移植后移植物抗宿主病的年龄分析

徐倚琪1，黄育铭2，吴学东1，冯晓勤1，刘  璇1，温建芸1，陈丽白1，阮永胜1   

  1. 1南方医科大学南方医院儿科，广东省广州市  510080；2南方医科大学附属广东省人民医院(广东省医学科学院)心导管室，广东省广州市  510080
  • 收稿日期:2025-08-15 接受日期:2025-12-16 出版日期:2026-11-08 发布日期:2026-05-23
  • 通讯作者: 阮永胜，博士，主治医师，南方医科大学南方医院儿科，广东省广州市 510080
  • 作者简介:徐倚琪，女，1992年生，汉族，2019年南方医科大学毕业，博士，主治医师，主要从事儿童血液病、化疗及造血干细胞移植相关临床工作及研究。
  • 基金资助:
    广州市科技计划项目(2023A04J2328)，项目负责人：徐倚琪；广州市科技计划项目(201607010241)，项目负责人：吴学东

Age analysis of graft-versus-host disease after fully matched hematopoietic stem cell transplantation in children with thalassemia

Xu Yiqi1, Huang Yuming2, Wu Xuedong1, Feng Xiaoqin1, Liu Xuan1, Wen Jianyun1, Chen Libai1, Ruan Yongsheng1   

  1. 1Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou 510080, Guangdong Province, China; 2Department of Catheterization Lab, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou 510080, Guangdong Province, China
  • Received:2025-08-15 Accepted:2025-12-16 Online:2026-11-08 Published:2026-05-23
  • Contact: Ruan Yongsheng, MD, Attending physician, Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou 510080, Guangdong Province, China
  • About author:Xu Yiqi, MD, Attending physician, Department of Pediatrics, Nanfang Hospital, Southern Medical University, Guangzhou 510080, Guangdong Province, China
  • Supported by:
    Guangzhou Science and Technology Project, No. 2023A04J2328 (to XYQ); Guangzhou Science and Technology Project, No. 201607010241 (to WXD)

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摘要：

文题释义：

移植物抗宿主病：是地中海贫血患者移植后的主要并发症之一，是指由移植物中的供者细胞识别出受者的抗原，从而攻击受者组织器官所产生的病理损伤，表现为包括胃肠道、皮肤、黏膜、肝脏和肺在内的多个器官系统的异质性症状。根据美国国立卫生研究院共识，可分为急性移植物抗宿主病和慢性移植物抗宿主病。
全相合造血干细胞移植：是指在进行造血干细胞移植时，供者与受者的人类白细胞抗原(HLA)配型完全相同，必须满足12个位点(包括A、B、C、DRB1、DQB1、DPB1)全部相合。

摘要
背景：移植物抗宿主病是地中海贫血患者在接受造血干细胞移植后所面临的一个主要并发症，也是导致患者发病率和非复发死亡率居高不下的主要原因。
目的：探究地中海贫血患儿造血干细胞移植后移植物抗宿主病的发生情况以及不同级别急性移植物抗宿主病的发生率与年龄的相关性。
方法：选取2012年1月至2018年6月南方医科大学南方医院儿科接受全相合造血干细胞移植治疗的地中海贫血患儿281例，按年龄分为< 5岁组(1组)80例、5-8岁组(2组)140例、> 8岁组(3组)61例，分析各组移植物抗宿主病发生情况。
结果与结论：共观察到44例移植物抗宿主病。1组、2组、3组移植物抗宿主病发生率分别为10%，14.29%，26.23%，P=0.026，表明移植物抗宿主病发生与年龄显著相关。13例慢性移植物抗宿主病患者中，1组、2组、3组的发生率分别为2.50%，3.57%，9.83%，P=0.049。34例急性移植物抗宿主病中，3个组Ⅰ级+Ⅱ级以及Ⅲ级+Ⅳ级急性移植物抗宿主病发生率差异均无显著性意义。结果表明，总移植物抗宿主病、慢性移植物抗宿主病的发生率与患儿年龄显著相关，8岁以上儿童发生率明显升高，提示对于年龄较大的地中海贫血移植患儿，需重点关注移植物抗宿主病的发生，提前做好预防和监测工作。

关键词: 地中海贫血, 造血干细胞移植, 移植物抗宿主病, 大龄儿童, 全相合, 年龄, 并发症, 发生率

Abstract: BACKGROUND: Graft-versus-host disease is a major complication faced by patients with thalassemia after hematopoietic stem cell transplantation and is the primary cause of high morbidity and non-relapse mortality.
OBJECTIVE: To investigate the situation of graft-versus-host disease in children with thalassemia after hematopoietic stem cell transplantation, and to explore the correlation between the incidence of different severity levels of acute graft-versus-host disease and the age of the children. 
METHODS: A total of 281 children with thalassemia who underwent fully matched hematopoietic stem cell transplantation in the Department of Pediatrics, Nanfang Hospital, Southern Medical University from January 2012 to June 2018 were selected. They were divided into three groups according to age: < 5 years old group (Group 1; n=80), 5-8 years old group (Group 2; n=140), and > 8 years old group (Group 3; n=61). The occurrence of graft-versus-host disease was analyzed in each group. 
RESULTS AND CONCLUSION: A total of 44 cases of graft-versus-host disease were observed. The incidence rates of graft-versus-host disease in Group 1, Group 2, and Group 3 were 10%, 14.29%, and 26.23%, respectively, with a P-value of 0.026, indicating a significant correlation between the occurrence of graft-versus-host disease and age. Among the 13 patients with chronic graft-versus-host disease, the incidence rates in Group 1, Group 2, and Group 3 were 2.50%, 3.57%, and 9.83%, respectively, with a P-value of 0.049 when comparing the incidence rates. For the 34 cases of acute graft-versus-host disease, there was no significant difference in the incidence rates of Grade I+II and Grade III+IV acute graft-versus-host disease among the three groups. The overall incidence rates of graft-versus-host disease and chronic graft-versus-host disease were significantly correlated with the age of the pediatric patients, with a notable increase in the occurrence of these conditions in children over 8 years old. This suggests that special attention should be given to the occurrence of graft-versus-host disease in older children undergoing thalassemia transplantation, and preventive and monitoring measures should be implemented in advance.

Key words: thalassemia, hematopoietic stem cell transplantation, graft-versus-host disease, older children, full match, age, complication, incidence rate

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