Parental haploidentical hematopoietic stem cell transplantation for treatment of hematologic malignancies

doi:10.3969/j.issn.2095-4344.2013.10.008

Abstract

Abstract:

BACKGROUND: The haploidentical hematopoietic stem cell transplantation is an effective treatment method of hematologic malignancies. It is very useful for increasing the successful rate of stem cell transplantation to find an appropriate donor rapidly.
OBJECTIVE: To compare the clinical effect of parental haploidentical hematopoietic stem cell transplantation for treatment of hematologic malignancies.
METHODS: Ninety-two patients with hematologic malignancies who underwent parental haploidentical hematopoietic stem cell transplantation were divided into four groups, including father-to-son transplantation group, father-to-daughter transplantation group, mother-to-son transplantation group and mother-to-daughter transplantation group. The incidence of graft versus host disease, recurrence rate, and 2-year disease-free survival and overall survival rate were compared between groups.
RESULTS AND CONCLUSION: Engraftment was successful in a total of 92 patients. There were no significant differences of incidence of acute graft versus host disease, chronic graft versus host disease and recurrence rate among four groups (P > 0.05). Significant difference was observed in the occurrence of Ⅲ-Ⅳ acute graft versus host disease, 2-year disease-free survival rate and 2-year overall survival rate among four groups (P < 0.05). The incidence of Ⅲ-Ⅳ acute graft versus host disease in father-to-son transplantation group and mother-to-daughter transplantation group was significantly lower than that in father-to-daughter transplantation group and mother-to-son transplantation group; 2-year disease-free survival rate and 2-year overall survival rate in the father-to-son transplantation group and mother-to-daughter transplantation group were higher than those in the father-to-daughter transplantation group and mother-to-son transplantation group. Parental haploidentical hematopoietic stem cell transplantation is safe and feasible, and the same gender of patients and donors have better effect than the different genders of patients and donors.

Key words: stem cells, stem cell transplantation, haploidentical, gender, graft versus host disease, survival rate, modified Bu/Cy+ATG, hematologic malignancies, clinical application of stem cells, stem cell photographs-containing paper

CLC Number:

R394.2

Wan Ding-ming, Shi Cong-cong, Xie Xin-sheng, Sun Ling, Sun Hui. Parental haploidentical hematopoietic stem cell transplantation for treatment of hematologic malignancies[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(10): 1753-1760.

Figures/Tables 5

2.4 父母供子女单倍型造血干细胞移植治疗恶性血液病的植入情况经红细胞表面抗原、染色体、微卫星标记检测，92例患者均获得完全植入。4组患者中性粒细胞≥0.5×109 L-1的中位时间分别为14 d(11-17 d)、14 d (9-19 d)、15 d(11-25 d)、16 d(10-23 d)；血小板≥20×109 L-1的中位时间分别为18 d(10-40 d)、14 d (10-30 d)、20 d(11-34 d)、13 d(11-15 d)。经比较发现4组间粒系、巨核系造血重建时间差异均无显著性意义(P > 0.05)。 2.5 父母供子女单倍型造血干细胞移植后急性移植物抗宿主病的发生情况急性移植物抗宿主病是指发生在移植后100 d以内，以皮肤、肝脏和胃肠道为主要表现的临床病理综合征[14]。急性移植物抗宿主病分为Ⅰ、Ⅱ、Ⅲ、Ⅳ度。经比较发现4组患者急性移植物抗宿主病的发生率差异无显著性意义(P > 0.05)。但4组Ⅲ、Ⅳ度急性移植物抗宿主病发生率差异存在显著性意义(P < 0.05)；其中父供子移植组、母供女移植组的Ⅲ、Ⅳ度急性移植物抗宿主病发生率低于父供女移植组和母供子移植组(P < 0.05)。而父供子移植组和母供女移植组间及父供女移植组和母供子移植组间Ⅲ、Ⅳ度急性移植物抗宿主病发生率差异无显著性意义(P > 0.05)，见表3。 2.6 父母供子女单倍型造血干细胞移植后慢性移植物抗宿主病的发生情况在超过100 d的随访中，父供子移植病例中发生慢性移植物抗宿主病的患者8例，发生率32%，其中4例为广泛型。父供女移植组10例发生慢性移植物抗宿主病，累计发生率37%，广泛型3例。母供子移植组中6例发生慢性移植物抗宿主病，累计发生率35%，广泛型3例。母供女移植组中8例发生慢性移植物抗宿主病，累计发生率35%，广泛型2例。4组患者慢性移植物抗宿主病的发生率差异无显著性意义(P > 0.05)。"

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