白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2010年
12期
714-717
,共4页
余正平%丁家华%陈宝安%高冲%孙耘玉%程坚%赵刚%王骏
餘正平%丁傢華%陳寶安%高遲%孫耘玉%程堅%趙剛%王駿
여정평%정가화%진보안%고충%손운옥%정견%조강%왕준
造血干细胞移植%移植,同种%移植物抗宿主病%HLA抗原%组织供者%回归分析
造血榦細胞移植%移植,同種%移植物抗宿主病%HLA抗原%組織供者%迴歸分析
조혈간세포이식%이식,동충%이식물항숙주병%HLA항원%조직공자%회귀분석
Hematopoietic stem cell transplantation%Transplantation,homologous%Graft vs host disease%HLA antigens%Tissue donors%Regression analysis
目的 探讨异基因造血干细胞移植(allo-HSCT)后急性移植物抗宿主病(aGVHD)的发生及其危险因素.方法 总结2004年10月至2008年12月治疗的72例allo-HSCT患者的临床资料.回顾性分析患者各临床因素与aGVHD发生的关系.结果 32例患者发生Ⅰ～Ⅳ度aGVHD,累积发生率44.4%.其中Ⅰ度8例(11.1%),Ⅱ度13例(18.1%),Ⅲ度7例(9.7%),Ⅳ度4例(5.6%).单因素分析显示疾病种类、抗人类T淋巴细胞球蛋白(ATG)的应用、疾病状态、预处理方案、供者类型、供受者血型不合、回输CD34+细胞数量、移植早期感染以及HLA配型均与aGVHD的发生有关(均P＜0.1).多因素分析(COX regression)确定不含ATG的GVHD预防方案(HR=2.94,P＜0.001)、HLA配型不合(HR=2.58,P＜0.005)以及无关供者(HR=1.97,P＜0.01)是发生aGVHD的主要危险因素.结论 aGVHD是allo-HSCT的重要并发症,HLA配型不合以及无关供者是aGVHD发生的主要危险因素.
目的 探討異基因造血榦細胞移植(allo-HSCT)後急性移植物抗宿主病(aGVHD)的髮生及其危險因素.方法 總結2004年10月至2008年12月治療的72例allo-HSCT患者的臨床資料.迴顧性分析患者各臨床因素與aGVHD髮生的關繫.結果 32例患者髮生Ⅰ～Ⅳ度aGVHD,纍積髮生率44.4%.其中Ⅰ度8例(11.1%),Ⅱ度13例(18.1%),Ⅲ度7例(9.7%),Ⅳ度4例(5.6%).單因素分析顯示疾病種類、抗人類T淋巴細胞毬蛋白(ATG)的應用、疾病狀態、預處理方案、供者類型、供受者血型不閤、迴輸CD34+細胞數量、移植早期感染以及HLA配型均與aGVHD的髮生有關(均P＜0.1).多因素分析(COX regression)確定不含ATG的GVHD預防方案(HR=2.94,P＜0.001)、HLA配型不閤(HR=2.58,P＜0.005)以及無關供者(HR=1.97,P＜0.01)是髮生aGVHD的主要危險因素.結論 aGVHD是allo-HSCT的重要併髮癥,HLA配型不閤以及無關供者是aGVHD髮生的主要危險因素.
목적 탐토이기인조혈간세포이식(allo-HSCT)후급성이식물항숙주병(aGVHD)적발생급기위험인소.방법 총결2004년10월지2008년12월치료적72례allo-HSCT환자적림상자료.회고성분석환자각림상인소여aGVHD발생적관계.결과 32례환자발생Ⅰ～Ⅳ도aGVHD,루적발생솔44.4%.기중Ⅰ도8례(11.1%),Ⅱ도13례(18.1%),Ⅲ도7례(9.7%),Ⅳ도4례(5.6%).단인소분석현시질병충류、항인류T림파세포구단백(ATG)적응용、질병상태、예처리방안、공자류형、공수자혈형불합、회수CD34+세포수량、이식조기감염이급HLA배형균여aGVHD적발생유관(균P＜0.1).다인소분석(COX regression)학정불함ATG적GVHD예방방안(HR=2.94,P＜0.001)、HLA배형불합(HR=2.58,P＜0.005)이급무관공자(HR=1.97,P＜0.01)시발생aGVHD적주요위험인소.결론 aGVHD시allo-HSCT적중요병발증,HLA배형불합이급무관공자시aGVHD발생적주요위험인소.
Objective To explore the incidence and risk factors of acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods The clinical data of 72 cases allo-HSCT from Oct 2004 to Dec 2008 were analyzed. Thirteen factors possibly correlated with the development of aGVHD were analyzed. Results aGVHD was developed in 32 cases (44.4 %), in which grades Ⅰ aGVHD was 11.1%, gradesⅡaGVHD was 18.1%, and grades Ⅲ-Ⅳ aGVHD was 15.3 %. The univariate analysis showed that diagnosis, the status of disease, use ATG, conditioning regimen, donor type,ABO blood group disparity between donor and recipient, CD34+ cell number, early engraftment and neutropenic infection, HLA locus were associated with the occurence of aGVHD (P ＜0.1). On the COX regression mode, an increased risk of aGVHD was associated with HLA mismatch (HR =2.58, P ＜0.005), GVHD prophylaxis without ATG (HR =2.94, P ＜ 0.001), and unrelated donor (HR =1.97, P ＜0.01). Conclusion aGVHD is a common complication after allo-HSCT, and HLA mismatch and unrelated donor are independent risk factors for aGVHD.
