摘要目的 探讨单份非血缘脐血移植(UCBT)治疗儿童高危急性淋巴细胞白血病(ALL)的疗效.方法 回顾性分析2008年9月至2014年12月安徽医科大学附属省立医院采用UCBT治疗高危ALL儿童66例的临床资料.患儿均采用强化清髓性预处理方案,分别为全身照射/环磷酰胺/阿糖胞苷(TBI/Cy/Ara-C) 13例,白消安/环磷酰胺/氟达拉滨(BU/Cy/Flu) 47例,BU/Cy/Ara-C 6例.环孢素联合短程霉酚酸酯预防移植物抗宿主病(GVHD).结果 所有患儿输入复温后脐血总有核细胞数为4.70(2.07～ 13.74)×107/kg,CD34+细胞中位数为2.40(0.73 ～9.89)×105/kg.移植后42 d中性粒细胞累积植入率为97.0％(64例),移植后120 d血小板累积植入率为87.6％(57例);中性粒细胞和血小板中位植入时间分别为移植后16(12～37)d和39(15～148)d.Ⅱ～Ⅳ度急性GVHD、Ⅲ～Ⅳ度急性GVHD和慢性GVHD发生率分别为27.3％(17例)、17.2％(10例)和10.3％(6例),可评估的360 d移植相关病死率为21.2％(14例),3年累积复发率为14.8％(9例),3年无病生存率和总体生存率分别为65.1％ (45例)和67.6％ (46例).结论 UCBT是治疗儿童高危ALL的一种安全有效的方法.

abstractsObjective To analyze the clinical outcomes of single unrelated umbilical cord blood transplantation (UCBT) in treating children with high risk acute lymphoblastic leukemia (ALL).Methods Between September 2008 and December 2014,a total of 66 consecutive pediatric patients with ALL received single UCBT treatment in Department of Hematology,Anhui Provincial Hospital Affiliated to Anhui Medical University.Myeloablative conditioning regimen was applied.The conditioning regimen consisted of total body irradiation (TBI) / Cyclophosphamide (Cy) / Cytarabine (Ara-C)in 13 patients,Busulfan(BU)/Cy/ Fludarabine(Flu) in 47 patients and BU/Cy/Ara-C in 6 patients.All patients received a combination of Cyclosporine and Mycophenolate mofetil for the prophylaxis of graft-versus-host disease (GVHD).Results The median dose of infused total nucleated cells and CD34 + cells were 4.70 (2.07-13.74) × 107/kg and 2.40 (0.73-9.89) × 105/kg.The cumulative incidence of neutrophil cells engraftment at day + 42 and platelet recovery at day + 120 was 97.0％ (64 cases) at a median of 16 (12-37) days after transplantation and 87.6％ (57 cases) with a median time of recovery of 39 (15-148) days,respectively.Incidence of grades Ⅱ-Ⅳ acute GVHD,grades Ⅲ-Ⅳ acute GVHD and chronic GVHD were 27.3％ (17 cases),17.2％ (10 cases),and 10.3％ (6 cases),respectively.The transplant-related mortality at 360 day was 21.2％ (14 cases).The 3-year cumulative incidence of relapse was 14.8％ (9 cases).The 3-year-disease-free survival and overall survival rates were 65.1％ (45 cases) and 67.6％ (46 cases),respectively.Conclusions For pediatric patients with high risk ALL,UCBT is a safe and effective treatment option.