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每个人都有供者:中国经验对全球单倍体造血干细胞移植实践的贡献。

Everyone has a donor: contribution of the Chinese experience to global practice of haploidentical hematopoietic stem cell transplantation.

机构信息

Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, 100044, China.

Peking-Tsinghua Center for Life Sciences, Beijing, 100044, China.

出版信息

Front Med. 2019 Feb;13(1):45-56. doi: 10.1007/s11684-017-0595-7. Epub 2018 Apr 19.

Abstract

Human leukocyte antigen (HLA)-matched donors for hematopoietic stem cell transplantation (HSCT) have long been scarce in China. Haploidentical (haplo) donors are available for the vast majority of patients, but toxicity has limited this approach. Three new approaches for haplo-HSCT originated from Italy, China, and USA in 1990 and have been developed to world-renowned system up to now. The Chinese approach have been greatly improved by implementing new individualized conditioning regimens, donor selection based on non-HLA systems, risk-directed strategies for graft-versus-host disease and relapse, and infection management. Haplo-HSCT has exhibited similar efficacy to HLA-matched HSCT and has gradually become the predominant donor source and the first alternative donor choice for allo-HSCT in China. Registry-based analyses and multicenter studies adhering to international standards facilitated the transformation of the unique Chinese experience into an inspiration for the refinement of global practice. This review will focus on how the new era in which "everyone has a donor" will become a reality in China.

摘要

人类白细胞抗原(HLA)匹配的造血干细胞移植(HSCT)供体在中国长期稀缺。大多数患者都可以使用单倍体(haplo)供体,但毒性限制了这种方法的应用。1990 年,来自意大利、中国和美国的三种新的单倍体 HSCT 方法得到了发展,并已成为举世闻名的系统。通过实施新的个体化预处理方案、基于非 HLA 系统的供者选择、移植物抗宿主病和复发的风险导向策略以及感染管理,中国方法得到了极大的改进。单倍体 HSCT 与 HLA 匹配 HSCT 具有相似的疗效,已逐渐成为中国同种异体 HSCT 的主要供体来源和首选供体选择。基于注册的分析和遵循国际标准的多中心研究促进了将独特的中国经验转化为全球实践精细化的灵感。这篇综述将重点介绍在中国,“人人都有供体”的新时代将如何成为现实。

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