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浙江大学学报（医学版）
浙江大学学报（医学版）  2018, Vol. 47 Issue (6): 651-658    DOI: 10.3785/j.issn.1008-9292.2018.12.14
综述     
异基因造血干细胞移植植入失败研究进展
曹丽芹(),施继敏*()
浙江大学医学院附属第一医院骨髓移植中心, 浙江 杭州 310003
Graft failure in allogeneic hematopoietic stem cell trans-plantation
CAO Liqin(),SHI Jimin*()
Center of Bone Marrow Transplantation, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
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摘要：

在过去20年里，随着医学技术和新药研制的发展，以及移植物抗宿主病疗效的提高，异基因造血干细胞移植（allo-HSCT）的预后得到了极大的改善，但植入失败仍是allo-HSCT术后面临的少见而严重的并发症。HLA不相合、病毒感染、供者高龄、原发病未缓解、骨髓造血微环境损伤、ABO血型不合、T细胞去除术、减剂量预处理方案、有核细胞数较低等均是导致植入失败的危险因素。近年来随着半相合造血干细胞移植的开展，供者特异性抗体在半相合植入失败中的作用引起关注。本文就近年来相关移植失败的机制、影响因素及其预防措施的研究进展作一综述。
关键词： 造血干细胞移植;  HLA抗原/分析;  抗体特异性;  活体供者;  移植物排斥;  危险因素;  综述    
Abstract:

With the progress of medical technology, the development of new drugs and the improvement of the therapeutic effect of graft-versus host disease in the last two decades, the outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) have been greatly improved. However, graft failure is still a rare but serious complication of allo-HSCT. HLA incompatibility, virus infection, elderly donor, uncontrolled primary disease, damage of bone marrow hematopoietic microenvironment, ABO blood group incompatibility, T cell depletion, reduced intensity conditioning, and low nucleated cell number are all risk factors for graft failure. In recent years, with the implementation of HLA haplo-identical hematopoietic stem cell transplantation, the role of donor-specific antibodies in graft failure has attracted attention increasingly. This article reviews the recent studies involving the mechanism, risk factors and prevention measures of graft failure in allo-HSCT.
Key words: Hematopoietic stem cell transplantation    HLA antigens/analysis    Antibody specificity    Living donors    Graft rejection    Risk factors    Review
收稿日期: 2018-03-23 出版日期: 2019-03-15
:  R55  
通讯作者: 施继敏     E-mail: 1401121270@qq.com;shijimin@zju.edu.cn
作者简介: 曹丽芹(1992-), 女, 硕士研究生, 主要从事造血干细胞移植植入失败的相关研究; E-mail:1401121270@qq.com; https://orcid.org/0000-0002-7441-4332
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引用本文:

曹丽芹,施继敏. 异基因造血干细胞移植植入失败研究进展[J]. 浙江大学学报（医学版）, 2018, 47(6): 651-658.

CAO Liqin,SHI Jimin. Graft failure in allogeneic hematopoietic stem cell trans-plantation. J Zhejiang Univ (Med Sci), 2018, 47(6): 651-658.

链接本文:

http://www.zjujournals.com/med/CN/10.3785/j.issn.1008-9292.2018.12.14    或    http://www.zjujournals.com/med/CN/Y2018/V47/I6/651

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