摘要
对1例Ph+染色体的急淋患儿进行母子间HLA半相合的异体外周血造血干细胞移植 ,为避免由于HLA不相合所产生的由T细胞介导的严重移植物抗宿主病(GVHD) ,采用了CD34+细胞正性分离去除淋巴细胞 ;同时为避免由于T细胞过度去除而引起宿主抗移植物反应(HVG)导致植入失败 ,在移植次日又加入部分T细胞 ,使病儿接受CD34 +细胞6×106/kg 和CD3 +细胞1.05×107/kg。结果 :随访1年来 ,红系、粒系和巨核系均恢复正常 ,临床上仅出现一过性的IIOaGVHD以及轻微的局限于口唇粘膜的cGVHD。STR位点DNA检验以及染色体检查 :移植后 +180天受体已从供体型嵌合体转为完全供体型 ,病儿获得植入成功。结果表明 ,常规剂量的CD34 +细胞移植加以适量CD3 +T细胞 ,可克服HLA部分不相配的难点 ,减轻GVHD ,同时也可避免由于过度的T细胞去除而出现的HVG。
One case of HLA haploidentical PBSCT from mother to the son was performed in the treatment of acute lymphoblastic leukemia with chromosom Ph+.To avoid severe 'graft versus host disease(GVHD)'following unmanipulated transplants,the positive selection method of CD34+cells with T cell depletion were used.Meanwhile,to avoid 'host versus graft(HVG)'following T cell_depleted transplants mediated by residual anti_donor cytotoxic T_lymphocyte(CTL) precursors that survived from the supralethal conditioning,suitable amount of T cells reinfusion by the addition of unmanipulated PBSC were performed on the next day.The patient received 6×106 CD34+ cells/kg and 1.05×107 CD34+ cells/kg totally. Thiskind of haploidentical transplantation was successful,with only moderate aGVHD and gentle cGVHD restricted only to lip.The conventional dosage of CD34+ cells plus suitable amount of CD3+ T cells transplantation can overcome the difficulty of GVHD or HVG in HLA partial mismatch,especially HLA haploidentical transplantation.
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2002年第1期28-30,53,共4页
Journal of Clinical Pediatrics
