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目的 :探讨HLA不全相合无血缘供者脐血移植 (UCBT)治疗血液系统恶性肿瘤造血重建、移植相关并发症的发生和生存情况。方法 :对 1例 15岁女性急性非淋巴细胞白血病 (ANLL)患者进行HLA 1个位点不相合2份UCBT。预处理方案 :采用白消安、环磷酰胺 (BU/CTX)方案 ,同时应用抗胸腺细胞球蛋白 (ATG)和Daclizumab(赛尼哌 ,zenapax)。移植物抗宿主病 (GVHD)的预防采用环孢菌素A(CsA)联合短程甲氨蝶呤 (MTX)和霉酚酸酯(MMF)方案。移植有核细胞数 (NC)为 4 .9× 10 7/kg ,CD34+ 细胞为 5 .36× 10 5/kg。结果 :中性粒细胞绝对计数 >0 .5× 10 9/L的时间为移植后第 15天 ;血小板计数 >5 0× 10 9/L的时间为移植后第 37天 ;全血细胞恢复正常的时间为移植后第 4 2天。移植后第 2 1天DNA指纹图提示供者型。受者已无病生存 2 0 0d。结论 :HLA 1个位点不相合的UCBT是可行的 ,对于体重量大的受者 2份脐血移植 (CBT)是可行的。
Objective: To investigate the occurrence and survival of hematopoietic reconstitution and transplantation-related complications of hematological malignancies treated with cord blood transplantation (UCBT) with incomplete HLA donor. Methods: One case of 15-year-old female patients with acute non-lymphocytic leukemia (ANLL) had 1 HLA-mismatched 2 UCBT. Pretreatment protocol: Busan, cyclophosphamide (BU / CTX) program, combined with anti-thymocyte globulin (ATG) and Daclizumab (Zenapo, zenapax). Prevention of graft-versus-host disease (GVHD) was based on cyclosporin A (CsA) in combination with short-course methotrexate (MTX) and mycophenolate mofetil (MMF) regimens. The number of transplanted nucleated cells (NC) was 4.9 × 10 7 / kg, and the amount of CD34 + cells was 5.36 × 10 5 / kg. Results: The absolute neutrophil count> 0.05 × 10 9 / L was on the 15th day after transplantation; the platelet count> 50 × 10 9 / L was on the 37th day after transplantation; the whole blood cells returned to normal The time was 42 days after transplantation. The DNA fingerprints on the 21st day after transplantation suggest donor type. Recipient has been disease-free 2 0 0d. CONCLUSION: UCBT with 1 HLA mismatch is feasible. It is feasible to use 2 cord blood transplantation (CBT) recipients with large body weight.