中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2012年
8期
615-618
,共4页
宋建君%任汉云%邱志祥%王茫桔%许蔚林%刘微%李渊%董玉君%尹玥%孙玉华%王莉红%欧晋平%王文生%岑溪南
宋建君%任漢雲%邱誌祥%王茫桔%許蔚林%劉微%李淵%董玉君%尹玥%孫玉華%王莉紅%歐晉平%王文生%岑溪南
송건군%임한운%구지상%왕망길%허위림%류미%리연%동옥군%윤모%손옥화%왕리홍%구진평%왕문생%잠계남
造血干细胞移植%慢性疾病状态
造血榦細胞移植%慢性疾病狀態
조혈간세포이식%만성질병상태
Hematopoietic stem cell transplantation%Chonic health conditions
目的 回顾性研究接受造血干细胞移植后获得长期生存受者的慢性疾病状态;对自体移植与异基因移植、异基因移植亲缘供者中HLA全相合与HLA不全相合组受者的慢性疾病状态分别进行比较研究.方法对接受造血干细胞移植且生存1年以上的101例受者,采用骨髓移植生存研究自评量表[Bone Marrow Transplant Survivor Study (BMTSS) questionnaire ]进行研究,将所得数据进行统计学分析.结果 造血干细胞移植获得长期生存的受者约48.5%继发1种或以上慢性并发症,其中83.7%为轻中度;异基因移植患者总得分为3分及以上的比例(32.1%)比自体移植患者(10.0%)高;亲缘HLA全相合移植受者总得分为1～2分、3～4分、≥5分者比例分别为23.5%、29.4%、14.7%,明显高于HLA不全相合移植受者(15.6%、15.6%、6.2%),慢性疾病状态多与慢性移植物抗宿主病相关;单因素分析显示,亲缘异基因造血干细胞移植的患者年龄、HLA全相合、预处理方案中包含抗胸腺细胞球蛋白(ATG)可影响移植后慢性疾病状态的发生.多因素分析发现移植时年龄为影响移植受者慢性疾病状态的唯一独立危险因素.结论 造血干细胞移植存活1年以上的受者其慢性疾病状态多为轻中度;亲缘HLA全相合移植受者慢性疾病状态较HLA不全相合移植受者严重.移植时年龄为影响亲缘异基因移植受者慢性疾病状态的独立危险因素.
目的 迴顧性研究接受造血榦細胞移植後穫得長期生存受者的慢性疾病狀態;對自體移植與異基因移植、異基因移植親緣供者中HLA全相閤與HLA不全相閤組受者的慢性疾病狀態分彆進行比較研究.方法對接受造血榦細胞移植且生存1年以上的101例受者,採用骨髓移植生存研究自評量錶[Bone Marrow Transplant Survivor Study (BMTSS) questionnaire ]進行研究,將所得數據進行統計學分析.結果 造血榦細胞移植穫得長期生存的受者約48.5%繼髮1種或以上慢性併髮癥,其中83.7%為輕中度;異基因移植患者總得分為3分及以上的比例(32.1%)比自體移植患者(10.0%)高;親緣HLA全相閤移植受者總得分為1～2分、3～4分、≥5分者比例分彆為23.5%、29.4%、14.7%,明顯高于HLA不全相閤移植受者(15.6%、15.6%、6.2%),慢性疾病狀態多與慢性移植物抗宿主病相關;單因素分析顯示,親緣異基因造血榦細胞移植的患者年齡、HLA全相閤、預處理方案中包含抗胸腺細胞毬蛋白(ATG)可影響移植後慢性疾病狀態的髮生.多因素分析髮現移植時年齡為影響移植受者慢性疾病狀態的唯一獨立危險因素.結論 造血榦細胞移植存活1年以上的受者其慢性疾病狀態多為輕中度;親緣HLA全相閤移植受者慢性疾病狀態較HLA不全相閤移植受者嚴重.移植時年齡為影響親緣異基因移植受者慢性疾病狀態的獨立危險因素.
목적 회고성연구접수조혈간세포이식후획득장기생존수자적만성질병상태;대자체이식여이기인이식、이기인이식친연공자중HLA전상합여HLA불전상합조수자적만성질병상태분별진행비교연구.방법대접수조혈간세포이식차생존1년이상적101례수자,채용골수이식생존연구자평량표[Bone Marrow Transplant Survivor Study (BMTSS) questionnaire ]진행연구,장소득수거진행통계학분석.결과 조혈간세포이식획득장기생존적수자약48.5%계발1충혹이상만성병발증,기중83.7%위경중도;이기인이식환자총득분위3분급이상적비례(32.1%)비자체이식환자(10.0%)고;친연HLA전상합이식수자총득분위1～2분、3～4분、≥5분자비례분별위23.5%、29.4%、14.7%,명현고우HLA불전상합이식수자(15.6%、15.6%、6.2%),만성질병상태다여만성이식물항숙주병상관;단인소분석현시,친연이기인조혈간세포이식적환자년령、HLA전상합、예처리방안중포함항흉선세포구단백(ATG)가영향이식후만성질병상태적발생.다인소분석발현이식시년령위영향이식수자만성질병상태적유일독립위험인소.결론 조혈간세포이식존활1년이상적수자기만성질병상태다위경중도;친연HLA전상합이식수자만성질병상태교HLA불전상합이식수자엄중.이식시년령위영향친연이기인이식수자만성질병상태적독립위험인소.
Objective To study the chronic health conditions(CHC) in long-term survival recipient after hematopoietic stem cell transplantation(HSCT). Methods The CHC of 101 cases survived for more than 1 year after HSCT were collected according to Bone Marrow Transplant Survivor Study(MBMTSS) questionnaire. The differences of the incidence and severity of CHC between auto-HSCT and allo-HSCT,HLA-matched and HLA-mismatched family donors HSCT were compared,and risk factors related to chronic health conditions were analysized retrospectively in family donor HSCT.Results Of the 101 HSCT survivors, 48.5% reported one or more chronic health conditions, and 83.7% of which were mild to moderate. The CHC in HLA-matched related donors HSCT were more serious than in HLA-mismatched related donors HSCT. The percentage of CHC total score above 3 in allo-HSCT recipients(32.1%) was higher than that in auto-HSCT ones(10.0%). The percentage of CHC total score 1-2, 3-4, and above 5 in HLA-matched family donors HSCT were 23.5%, 29.4%, and 14.7%,respectively, being significantly higher than those in HLA-mismatched ones(15.6%, 15.6%, and 6.2%, respectively). CHC was mainly related to chronic graft-versus-host disease(cGVHD). Single variable analysis showed that younger age at time of transplantation, HLA fully matched, the use of antithymocyte globulin(ATG) in the conditioning regimens were favorable for CHC. COX-regression Model showed that age was the only independent risk factor for predicting the CHC in family donor HSCT. Conclusion The chronic health conditions after HSCT is mild to moderate, these complications in HLA-matched related donor HSCT are more serious than those in HLA-mismatched related donor HSCT. The age at transplantation is the only independent risk factor for chronic health conditions.
