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.
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。