Kang Hui-Zhu, Zheng Xiao-Li, Wang Zhi-Dong, Han Dong-Mei, Ding Li, Yan Hong-Min, Wang Heng-Xiang
Department of Hematology, General Hospital of Chinese Air Force, Beijing 100142, China.
Department of Hematology, General Hospital of Chinese Air Force, Beijing 100142, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017 Aug;25(4):1151-1157. doi: 10.7534/j.issn.1009-2137.2017.04.034.
To analyse the efficacy and safety of co-transplantation of umbilical cord mesenchymal stem cell(UC-MSC) with haploidentical hematopoietic stem cell transplantation(hi-HSCT) in children with hematologic malignancy.
The clinical data of 47 children undergoing hi-HSCT were retrospectively analyzed from November 2003 to November 2014, among them 34 patients received UC-MSC from October 2011 to November 2014, and another 13 patients without UC-MSC from November 2003 to September 2011. The median follow-up time was 20(0.5-67) months.
No adverse events were observed after the UC-MSC transplantation. The engraftment rate, the median neutrophils engraftment time and platelet engraftment time all were not significantly different between hi-HSCT and hi-HSCT+UC-MSCT(P>0.05). The three-years cumulative overall survival (70.6% vs 23.1%),(P=0.004), three-years cumulative disease-free survival(52.9% vs 0) (P=0), and early cytomegalovirus (CMV) viremia (91.2% vs 38.5%) (P=0) in UC-MSC+hi-HSCT group were statistically significantly higher than that in the conventional hi-HSCT group. The morbidity of aGVHD (44.1% vs 92.3%) (P=0.003), I-II aGVHD (26.5% vs 61.5%) (P=0.041) and transplantation-related mortality (11.8% vs 46.2%) (P=0.017) in UC-MSC+hi-HSCT group was statistically significantly lower than that in hi-HSCT group, however, the morbidity of III-IV aGVHD (17.6% vs 30.8%), cGVHD (26.5% vs 30.8%), HC (35.3% vs 7.7%), pulmonary infection (52.9% vs 46.2%) and relapse rate (32.4% vs 53.8%) were not statistically significantly different (P>0.05) between the 2 groups.
The application of umbilical cord mesenchymal stem cell in children undergoing hi-HSCT is safe, the UC-MSC can improve the overall survival, disease-free survival and reduce transplantation-related mortality. UC-MSC can reduce the morbidity of aGVHD, but increase the early infection of CMV, however it is nothing for the pulmonary infection and relapse in the children after hi-HSCT.
分析脐带间充质干细胞（UC-MSC）与单倍体造血干细胞移植（hi-HSCT）联合移植治疗儿童血液系统恶性肿瘤的疗效及安全性。
回顾性分析2003年11月至2014年11月期间接受hi-HSCT的47例儿童的临床资料，其中34例患者于2011年10月至2014年11月接受了UC-MSC移植，另外13例患者于2003年11月至2011年9月未接受UC-MSC移植。中位随访时间为20（0.5-67）个月。
UC-MSC移植后未观察到不良事件。hi-HSCT组与hi-HSCT+UC-MSCT组之间的植入率、中性粒细胞中位植入时间和血小板植入时间均无显著差异（P>0.05）。UC-MSC+hi-HSCT组的三年累积总生存率（70.6%对23.1%），（P=0.004），三年累积无病生存率（52.9%对0）（P=0），以及早期巨细胞病毒（CMV）病毒血症（91.2%对38.5%）（P=0）在统计学上显著高于传统hi-HSCT组。UC-MSC+hi-HSCT组的急性移植物抗宿主病（aGVHD）发病率（44.1%对92.3%）（P=0.003）、I-II级aGVHD（26.5%对61.5%）（P=0.041）和移植相关死亡率（11.8%对46.2%）（P=0.017）在统计学上显著低于hi-HSCT组，然而，III-IV级aGVHD发病率（17.6%对30.8%）、慢性移植物抗宿主病（cGVHD）（26.5%对30.8%）、出血性膀胱炎（HC）（35.3%对7.7%）、肺部感染（52.9%对46.2%）和复发率（32.4%对53.8%）在两组之间无统计学显著差异（P>0.05）。
脐带间充质干细胞在接受hi-HSCT的儿童中的应用是安全的，UC-MSC可提高总生存率、无病生存率并降低移植相关死亡率。UC-MSC可降低aGVHD的发病率，但增加CMV的早期感染，然而对hi-HSCT后儿童的肺部感染和复发无影响。
