Vanichsetakul Preeda, O-Charoen Rachanee, Seksarn Panya, Kupatawintu Pawinee
Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2005 Sep;88 Suppl 4:S1-6.
The authors evaluated the outcome of ten children given hematopoietic stem cell transplantations from Thai unrelated donors (URD-HSCT) selected using DNA high-resolution typing of both HLA class I and II loci. Six patient/donor pairs (60%) were fully matched; four (40%) were 5/6 matched. Patients had either non-malignant (n=9) or malignant (n=1) diseases. In most cases, graft-versus-host disease (GVHD) prophylaxis composed of cyclosporine and short-term methotrexate. The probability of hematopoietic recovery at day 30 was 90%. The cumulative probability of acute GVHD and of chronic GVHD equaled 44.4 and 0%, respectively. Three patients died of transplant-related complications. The probability of transplant-related mortality (TRM) at 30, 100, and 180 days were 10, 30, and 30%, respectively. The overall and disease-free survival rates were 70 and 70%, respectively. URD-HSCT with donor selection based on high-resolution HLA typing is associated with a low incidence of both severe acute GVHD and graft failure. The observed outcome is comparable to that of children transplanted from HLA-identical siblings.
作者评估了10名接受泰国无关供者造血干细胞移植（URD-HSCT）儿童的结局，这些供者是通过对HLA I类和II类基因座进行DNA高分辨率分型挑选出来的。6对患者/供者（60%）完全匹配；4对（40%）为5/6匹配。患者患有非恶性疾病（n=9）或恶性疾病（n=1）。在大多数情况下，移植物抗宿主病（GVHD）预防方案由环孢素和短期甲氨蝶呤组成。第30天时造血恢复的概率为90%。急性GVHD和慢性GVHD的累积概率分别为44.4%和0%。3名患者死于移植相关并发症。第30、100和180天时移植相关死亡率（TRM）分别为10%、30%和30%。总生存率和无病生存率分别为70%和70%。基于高分辨率HLA分型选择供者的URD-HSCT与严重急性GVHD和移植物失败的低发生率相关。观察到的结局与接受HLA相同同胞移植的儿童相当。
