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目的观察单体型相合造血干细胞移植及全相合异基因造血干细胞移植后骨髓形态学差异及造血重建情况。方法在235名实施异基因造血干细胞移植患者中,单体型相合120名,采用外周血造血干细胞联合骨髓移植;115名全相合的患者,采用单纯的外周血造血干细胞移植。在造血干细胞移植成功出层流室+30 d行骨髓穿刺抽吸涂片观察骨髓形态学差异,并观察造血重建情况。结果 235名患者均成功重建造血。全相合患者白细胞及血小板重建的时间分别14.7 d(12～26 d)及20.6 d(13～32 d);单体型相合造血干细胞移植患者白细胞及血小板重建的时间分别12 d(10～21 d)及18 d(15～30 d);2者之间的差异具有统计学意义(P<0.05)。2组患者造血干细胞移植后骨髓全部完全缓解。在骨髓增生程度、粒红比例和细胞形态等方面有差异,但差异无统计学意义(P>0.05)。结论单体型相合造血干细胞移植较全相合移植造血重建早,移植后骨髓形态学有差异,但差异无统计学意义。
Objective To observe the difference of bone marrow morphology and hematopoietic reconstitution after haploidentical hematopoietic stem cell transplantation and allogeneic allogeneic hematopoietic stem cell transplantation. Methods Thirty-two haploidentical hematopoietic stem cell transplantation patients were haplotype matched with peripheral blood stem cells combined with bone marrow transplantation. One hundred and fifteen patients who were fully matched were treated with simple peripheral blood stem cell transplantation. The hematopoietic stem cell transplantation successfully out of the laminar flow chamber +30 d bone marrow aspirate smear observed bone marrow morphological differences, and observed the situation of hematopoietic reconstitution. Results All 235 patients were successfully reconstructed. The duration of leukocyte and platelet reconstruction was 14.7 days (12-26 days) and 20.6 days (13-32 days) respectively in patients with complete coincidence. The duration of leukocyte and platelet reconstruction in patients with haploidentical HSCT was 12 days (10-21 days) ) And 18 days (15 ~ 30 days). The difference between the two groups was statistically significant (P <0.05). Bone marrow was completely relieved after hematopoietic stem cell transplantation in both groups. There were differences in the degree of myeloproliferation, the proportion of granulocytes and cell morphology, but the difference was not statistically significant (P> 0.05). Conclusions Monosomy of matched hematopoietic stem cell transplantation is better than that of full reconstructive hematopoietic reconstitution. There is a difference in bone marrow morphology after transplantation, but the difference is not statistically significant.