脐血联合单倍型造血干细胞共移植治疗恶性血液病的研究进展

摘要: 单倍型造血干细胞移植（haploidentical hematopoietic stem cell transplantation，haplo-HSCT）近年来被广泛应用，减轻移植物抗宿主病（graft-versus-host disease，GVHD）发生率，减少移植后并发症、提高患者生存质量为目前临床亟待解决的问题。脐血联合haplo-HSCT已逐渐在国内外部分中心开展，其可以克服haplo-HSCT和脐血干细胞移植的局限性，并保留单倍型移植物抗白血病的作用，在加速造血重建、降低GVHD发生率等方面显示出一定的疗效和应用前景，并且可取得与人类白细胞组织相容性抗原（human leukocyte antigen，HLA）全相合移植类似的疗效。本文就该移植方案的疗效及影响因素，并对移植后病毒感染、免疫重建、造血嵌合状态等进行综述，旨在为临床应用提供参考。
- 脐血 /
- 单倍型造血干细胞移植 /
- 恶性血液病 /
- 移植物抗宿主病 /
- 病毒感染
Abstract: In recent years, haploidentical hematopoietic stem cell transplantation (haplo- HSCT) has been widely used. At present, there are urgent clinical challenges that need to be solved: how to reduce the incidence of graft-versus-host disease (GVHD), manage the complications of transplantation, and improve the quality of life of the patients? Co-transplantation of umbilical cord blood and haploidentical hematopoietic stem cells has been gradually carried out in some centers at home and abroad. It could overcome the limitations of haplo-HSCT and umbilical cord blood stem cell transplantation and retain the effect of haploidentical grafts on leukemia. Co-transplantation shows certain curative effects and has potential applications in accelerating hematopoietic reconstruction and reducing the incidence of GVHD. Co-transplantation could achieve curative effects similar to those of human leukocyte antigen (HLA)- matched transplantation. This review summarizes the efficacy and influencing factors of this co-transplantation regimen and summarizes the issues of viral infection, immune reconstitution, and hematopoietic chimerism after transplantation, to provide a reference for extending the clinical application of this regimen in the future.
- cord blood /
- haploidentical hematopoietic stem cell transplantation (haplo-HSCT) /
- hematological malignancies /
- graft-versushost disease (GVHD) /
- viral infection

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