Hua Fang, Zhang Shan, Zhang Xiaomei, Deng Yan, Han Ying, Lai Sihan, He Ying, Ma Lei, Zhang Xupai, Chen Dan, Su Yi, Xiao Jian, Zhang Ling, Yang Hui, Huang Rong, Hu Haiyan, Chen Mingli, He Guangcui, Yao Hao, Yi Hai
Department of Hematology, The General Hospital of Western Theater Command, Sichuan Clinical Research Center for Hematological Disease, Branch of National Clinical Research Center for Hematological Disease, Chengdu, China.
Department of Hematology, Zigong First People's Hospital, Zigong, China.
Cell Transplant. 2025 Jan-Dec;34:9636897251359786. doi: 10.1177/09636897251359786. Epub 2025 Jul 25.
Haploidentical hematopoietic stem cell transplantation (Haplo-HSCT) provides cure opportunity for patients requiring prompt allogeneic HSCT but failing to identify well-matched donor, but its outcomes are potentially impaired by increased transplant-related mortality (TRM). We performed haplo-HSCT using granulocyte colony-stimulating factor (G-CSF)-primed peripheral blood stem cells (PBSCs), umbilical cord mesenchymal stem cells (UC-MSCs) and third-party unrelated umbilical cord blood (UCB) stem cells. Modified "Beijing protocol" were performed in this study. All of the patients were transplanted by Busulfan or TBI-based regimen. Anti-thymocyte globulin were used to T-cell depletion . Cyclosporine, mycophenolate mofetil, and short course methotrexate were used to prevent graft-versus-host disease (GVHD). One hundred and sixty-five patients with hematological disorders undergoing haplo-HSCT from Jan 2021 to Nov 2023 were included in this study. The median time of neutrophil engraftment were 12 days (range: 9-25 days), and the median time of platelet engraftment were 13 days (range: 6-50 days). Full haploidentical donor chimerism were obtained within 30 days. No evidence of UCB chimerism was found. Twenty-five patients developed acute GVHD. The incidence of grade II-IV and grade III-IV acute GVHD was 12.73% and 6.67%, respectively. Twenty-eight patients developed chronic GVHD, 10 were limited (6.06%) and 18 were extensive (10.91%). The TRM is total of 26 deaths (15.8%) and the cumulative incidence of relapse (CIR) is total of 17 deaths (11.8%) occurred as of the statistical period. The 2 years overall survival (OS) rate is 72.96%. The median overall survival rate was not reached. Haplo-HSCT performed by PBSCs, UC-MSCs and UCB "triple-infusion" achieved excellent outcomes, and need to explored in a larger cohort.
单倍体相合造血干细胞移植（Haplo-HSCT）为那些需要立即进行异基因造血干细胞移植但未能找到完全匹配供体的患者提供了治愈机会，但其结果可能会因移植相关死亡率（TRM）的增加而受到影响。我们使用粒细胞集落刺激因子（G-CSF）动员的外周血干细胞（PBSCs）、脐带间充质干细胞（UC-MSCs）和第三方无关脐带血（UCB）干细胞进行了单倍体相合造血干细胞移植。本研究采用了改良的“北京方案”。所有患者均采用基于白消安或全身照射（TBI）的方案进行移植。使用抗胸腺细胞球蛋白进行T细胞清除。使用环孢素、霉酚酸酯和短疗程甲氨蝶呤预防移植物抗宿主病（GVHD）。本研究纳入了2021年1月至2023年11月期间接受单倍体相合造血干细胞移植的165例血液系统疾病患者。中性粒细胞植入的中位时间为12天（范围：9 - 25天），血小板植入的中位时间为13天（范围：6 - 50天）。在30天内获得了完全的单倍体相合供体嵌合体。未发现脐带血嵌合体的证据。25例患者发生了急性移植物抗宿主病。II-IV级和III-IV级急性移植物抗宿主病的发生率分别为12.73%和6.67%。28例患者发生了慢性移植物抗宿主病，10例为局限性（6.06%），18例为广泛性（10.91%）。截至统计期，移植相关死亡率总计26例死亡（15.8%），复发累积发生率（CIR）总计17例死亡（11.8%）。2年总生存率（OS）为72.96%。中位总生存率未达到。通过外周血干细胞、脐带间充质干细胞和脐带血“三联输注”进行的单倍体相合造血干细胞移植取得了优异的结果，需要在更大的队列中进行探索。
