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回顾性分析异基因造血干细胞移植(Allo-HSCT)治疗骨髓增生异常综合征(MDS)的适应证、治疗时机、移植物的选择、移植预处理方案的选择和移植疗效。22例患者中21例获得造血重建,1例非血缘脐血移植(UCBT)未获得植入的成人患者,于非血缘脐血移植(UCBT)后38 d进行母亲HLA4/6相合的外周血联合骨髓造血干细胞移植解救治疗获得植入。22例中死亡3例,无1例复发。MDS患者何时进行Allo-HSCT需依据国际预后积分系统(IPSS)对患者分组,评分属于高危组的患者宜在疾病确诊后尽早进行移植,而低危组的患者可在其他药物治疗效果不佳的时候进行;不仅可选择血缘关系的骨髓移植(BMT)和外周血造血干细胞移植(PBSCT),也可进行非血缘人类白细胞共同抗原(HLA)不全相合的UCBT;移植预处理如采用减低强度的方案(RIC)并不影响移植效果。
The indications, timing of treatment, selection of allografts, selection of transplantation preconditioning options and transplantation efficacy of allogeneic hematopoietic stem cell transplantation (Allo-HSCT) in treatment of myelodysplastic syndrome (MDS) were retrospectively analyzed. Twenty-one of the 22 patients underwent hematopoietic reconstitution and 1 adult non-associated cord blood transplant (UCBT) did not receive an implanted adult patient. Maternal HLA-4/6 matched peripheral blood was combined 38 days after non-blood-borne cord blood transplantation (UCBT) Bone marrow hematopoietic stem cell transplantation for rescue treatment. Among the 22 cases, 3 died and none had recurrence. Patients with MDS should be grouped according to the International Prognostic Score System (IPSS) when allo-HSCT is performed, and patients with high-risk scores should be transplanted as soon as possible after diagnosis of the disease, while patients in lower-risk groups may be less effective than other medications ; Not only can choose the blood relationship of bone marrow transplantation (BMT) and peripheral blood stem cell transplantation (PBSCT), can also be non-HLA-incompatible HLA-matched UCBT; transplant pretreatment such as the use of reduced intensity Program (RIC) does not affect the transplant effect.