脐带间充质干细胞治疗重度急性移植物抗宿主病安全有效

张凌风.脐带间充质干细胞治疗重度急性移植物抗宿主病安全有效[J].内科急危重症杂志,2025,31(1):54-57

DOI：10.11768/nkjwzzzz20250109

中文关键词: 异基因造血干细胞移植急性移植物抗宿主病脐带间充质干细胞疗效

英文关键词:

基金项目:科技部国家重点研发计划(2021YFA1101504)；湖北省重点研发计划（2022BCA017）

作者	单位	E-mail
张凌风	华中科技大学同济医学院附属同济医院	yczhang@tjh.tjmu.edu.cn

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中文摘要:

摘要目的：探讨脐带间充质干细胞（MSCs）治疗异基因造血干细胞移植后急性移植物抗宿主病（aGVHD）的疗效与安全性。方法：回顾性分析接受免疫抑制剂联合脐带MSCs治疗的Ⅲ度以上aGVHD患者30例，描述患者一般情况及预后、MSCs疗效及安全性，比较回输时间点对疗效的影响及回输前后患者血象变化情况。结果：30例患者总体客观缓解率为70%，其中17例（56.67%）完全缓解，4例（13.33%）部分缓解，9例（30%）无效。患者使用MSCs期间均未出现输注相关不良反应。中位随访时间为165（27，1398）d，3年总体生存期为53.08%。发病2周内回输MSCs的疗效优于2周后回输（P＜0.05）。回输MSCs30d后白细胞、中性粒细胞及血小板计数减少（P均＜0.05）。结论：脐带MSCs治疗移植后重度aGVHD是安全有效的。

英文摘要:

Abstract Objective: To investigate the therapeutic efficacy and safety of umbilical cord mesenchymal stem cells (MSCs) in treating acute graft-versus-host disease (aGVHD) following allogeneic hematopoietic stem cell transplantation. Methods: A retrospective analysis was conducted on 30 patients with grade III or higher aGVHD who underwent immunosuppressive agents combined with umbilical cord MSCs treatment. The patients' general conditions and prognoses, along with the efficacy and safety of MSCs treatment, were described. The study compared the effects of different infusion timing on the treatment outcome and analyzed the changes in blood counts before and after the infusion. Results: The overall objective response rate (ORR) among the 30 patients was 70%, with 17 patients achieving complete remission (CR), 4 patients achieving partial remission (PR), and 9 patients showing no response (NR). Throughout the use of MSCs, no infusion-related adverse reactions were reported by the patients. The median follow-up duration was 165 days (range 27 to 1398 days), with a 3-year overall survival (OS) rate of 53.08%. Infusing MSCs within 2 weeks of symptom onset led to superior efficacy compared to infusing them after 2 weeks (P< 0.05). At 30 days post-MSCs infusion, white blood cell count, neutrophil count, and platelet count were reduced (P< 0.05). Conclusion: Umbilical cord MSCs are both effective and safe in treating severe aGVHD post-transplantation.