Abstract
目的评价异基因造血干细胞移植（allo-HSCT）治疗重型再生障碍性贫血（SAA）患者的疗效。方法回顾性分析2001年10月至2015年5月接受allo-HSCT治疗的41例SAA患者的临床资料。其中男27例，女14例，中位年龄为17(2~43）岁。其中同胞相合移植24例，无关供者移植17例。结果38例患者移植后获得造血重建，造血重建率为92.68%。可评估患者的中性粒细胞和血小板的中位植入时间分别为16(10~57) d和20(9~83) d。13例发生急性移植物抗宿主病（aGVHD），8例发生慢性移植物抗宿主病，5例发生移植物排斥反应。中位随访27(3~154）个月，预期3年总生存（OS）率为（75.1±8.3）%。10例患者死亡，移植相关死亡率为24.39%。多因素分析结果显示：移植后发生Ⅱ~Ⅳ度aGVHD[P=0.018，OR=27.481(95% CI 2.377~392.636）]和侵袭性真菌病[P=0.021，OR=21.364(95% CI 1.732~354.185）]为影响SAA患者allo-HSCT后OS的独立危险因素。结论同胞相合供者和HLA匹配的无关供者allo-HSCT是治疗SAA患者的有效手段，Ⅱ~Ⅳ度aGVHD和侵袭性真菌病与移植后OS率较低有关。
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