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脐带血和脐带间充质干细胞联合低剂量免疫抑制剂治疗老年纯红细胞再生障碍性贫血:病例系列

Umbilical Cord Blood and UC-MSCs Combined with Low-Dose Immunosuppressant in the Treatment of Elderly Patients with Pure Red Cell Aplastic: A Case Series.

作者信息

Zhu Wei-Wei, Zhuang Sujing, Yu Zhe, Li Xin, Han Tian-Jie, Ma Yue, Li Li-Jun, Zhao Zhi-Rui

机构信息

Department of Hematology, Shandong Provincial Third Hospital, Jinan, 250031, China.

Shandong Qilu Stem Cell Engineering Co.LTD, Jinan, 250102, China.

出版信息

Curr Stem Cell Res Ther. 2025;20(3):350-355. doi: 10.2174/011574888X290378240424075002.

Abstract

INTRODUCTION

At present, cyclosporine (CsA) is the first-line treatment for Pure Red Cell Aplasia (PRCA), but CsA administration can be associated with a number of side effects due to its high toxicity. Therefore, it is urgent to explore a safe and effective treatment for elderly patients who cannot be treated with conventional doses of CsA, especially those with multiple complications. Allogeneic Stem Cell Transplantation (ASCT) for PRCA is a promising treatment, but reports of using umbilical cord blood (UCB) are very rare.

CASE PRESENTATION

In this report, UCB and umbilical cord mesenchymal stem cells (UC-MSCs) combined with low-dose CsA (1-3mg/kg/d) were used to treat 3 elderly patients who were diagnosed with PRCA combined with multiple complications in heart, lung, and renal. The treatments were successful without complications, and 12 months after stem cell infusion, the blood tests of the patients came normal. Moreover, the function of the liver, heart, and kidney continued to be stable.

CONCLUSION

This report provides an effective regimen of using UCB and UC-MSCs combined with low-dose CsA (1-3 mg/kg/d) to treat PRCA, especially for elderly patients with multiple complications who cannot use the conventional dosage.

摘要

引言

目前,环孢素(CsA)是纯红细胞再生障碍性贫血(PRCA)的一线治疗药物,但由于其高毒性,CsA给药可能会伴随多种副作用。因此,迫切需要探索一种安全有效的治疗方法,用于无法接受常规剂量CsA治疗的老年患者,尤其是那些伴有多种并发症的患者。PRCA的异基因干细胞移植(ASCT)是一种有前景的治疗方法,但使用脐带血(UCB)的报道非常罕见。

病例报告

在本报告中,UCB和脐带间充质干细胞(UC-MSCs)联合低剂量CsA(1-3mg/kg/d)用于治疗3例诊断为PRCA合并心、肺、肾多种并发症的老年患者。治疗成功且无并发症,干细胞输注12个月后,患者血液检查恢复正常。此外,肝、心、肾功能持续稳定。

结论

本报告提供了一种使用UCB和UC-MSCs联合低剂量CsA(1-3mg/kg/d)治疗PRCA的有效方案,尤其适用于无法使用常规剂量的伴有多种并发症的老年患者。

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