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目的探讨异基因造血干细胞移植在儿童再生障碍性贫血治疗中的作用。方法10例再障患儿中,5例行HLA相合同胞供者异基因外周造血干细胞移植,3例行无关供者异基因外周造血干细胞移植,1例行无关供者骨髓移植,1例行脐血移植。结果1例接受脐血移植者未植活,其余9例均植入。中位植入时间14d(8～24d),中性粒细胞>0.5×109/L中位时间12d(8～19d),血小板>20×109/L中位时间17d(9～40d)。2例发生排斥,1例接受了第二次移植,1例移植后3个月血象开始自行恢复。结论如有HLA相合的同胞供者,异基因造血干细胞移植可作为儿童再障的一线治疗;临床重症感染无法控制的患儿,并非移植绝对反指征,相反可通过移植后的造血重建控制感染。
Objective To investigate the role of allogeneic hematopoietic stem cell transplantation in the treatment of pediatric aplastic anemia. Methods Among 10 children with aplastic anemia, 5 received HLA-matched sibling donor allogeneic peripheral blood stem cell transplantation, 3 received unrelated donors allogeneic peripheral blood stem cell transplantation, 1 received non-donor donor bone marrow transplantation, and 1 received umbilicus Blood transplant. Results 1 case of umbilical cord blood transplants were not alive, and the remaining 9 cases were implanted. The median time of implantation was 14 days (8 ~ 24 days), neutrophil> 0.5 × 109 / L was 12 days (8 ~ 19 days), and platelets> 20 × 109 / L was 17 days (9 ~ 40 days). 2 cases of rejection, 1 case received a second transplant, 1 case of blood 3 months after transplantation began to self-recovery. Conclusion Allogeneic hematopoietic stem cell transplantation can be used as a first-line treatment for children with aplastic anemia if HLA-matched sibling donors. In children with uncontrollable severe clinical infection, the transplanted hematopoietic reconstitution can not be controlled. .