中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2011年
4期
283-286
,共4页
余正平%丁家华%陈宝安%吴芬%高冲%孙耘玉%程坚%赵刚%王骏%李玉峰%丁邦和%钱军
餘正平%丁傢華%陳寶安%吳芬%高遲%孫耘玉%程堅%趙剛%王駿%李玉峰%丁邦和%錢軍
여정평%정가화%진보안%오분%고충%손운옥%정견%조강%왕준%리옥봉%정방화%전군
异基因造血干细胞移植%血液肿瘤%复发%移植物抗宿主病%移植物抗白血病
異基因造血榦細胞移植%血液腫瘤%複髮%移植物抗宿主病%移植物抗白血病
이기인조혈간세포이식%혈액종류%복발%이식물항숙주병%이식물항백혈병
Allogeneic hematopoietic stem cell transplantation%Hematologic neoplasms%Relapse%Graft-versus-host neoplasms%Graft-versus-leukemia
目的 探讨异基因造血干细胞移植(allo-HSCT)后复发的危险囚素.方法 总结82例接受allo-HSCT治疗的血液病患者的临床资料,分析供受者年龄、供受者性别、供受者血型异同、供者类型、疾病状态、HLA配型、预处理方案、移植物抗宿主病(GVHD)的有无、回输CD34+细胞数量、有无巨细胞病毒感染等与移植后复发的关系.结果 16例患者在移植后2～28个月复发.单因素分析结果显示,疾病状态(P=0.013)、疾病诊断到移植的时间(P=0.042)、预处理方案(P=0.046)、急性GVHD(P=0.022)、慢性GVHD(P=0.002)与allo-HSCT后复发有关.Cox多因素回归分析结果显示,疾病状态(OR=2.58,95%CI为1.26～5.01)、疾病诊断到移植的时间(OR=1.98,95%CI为1.11～3.63)和慢性GVHD(OR=3.74,95%CI为1.96～7.97)是allo-HSCT后复发的独立影响因素.结论 复发仍是allo-HSCT失败的首要原因,疾病状态、疾病诊断到移植的时间以及无慢性GVHD是移植后复发的主要危险因素.
目的 探討異基因造血榦細胞移植(allo-HSCT)後複髮的危險囚素.方法 總結82例接受allo-HSCT治療的血液病患者的臨床資料,分析供受者年齡、供受者性彆、供受者血型異同、供者類型、疾病狀態、HLA配型、預處理方案、移植物抗宿主病(GVHD)的有無、迴輸CD34+細胞數量、有無巨細胞病毒感染等與移植後複髮的關繫.結果 16例患者在移植後2～28箇月複髮.單因素分析結果顯示,疾病狀態(P=0.013)、疾病診斷到移植的時間(P=0.042)、預處理方案(P=0.046)、急性GVHD(P=0.022)、慢性GVHD(P=0.002)與allo-HSCT後複髮有關.Cox多因素迴歸分析結果顯示,疾病狀態(OR=2.58,95%CI為1.26～5.01)、疾病診斷到移植的時間(OR=1.98,95%CI為1.11～3.63)和慢性GVHD(OR=3.74,95%CI為1.96～7.97)是allo-HSCT後複髮的獨立影響因素.結論 複髮仍是allo-HSCT失敗的首要原因,疾病狀態、疾病診斷到移植的時間以及無慢性GVHD是移植後複髮的主要危險因素.
목적 탐토이기인조혈간세포이식(allo-HSCT)후복발적위험수소.방법 총결82례접수allo-HSCT치료적혈액병환자적림상자료,분석공수자년령、공수자성별、공수자혈형이동、공자류형、질병상태、HLA배형、예처리방안、이식물항숙주병(GVHD)적유무、회수CD34+세포수량、유무거세포병독감염등여이식후복발적관계.결과 16례환자재이식후2～28개월복발.단인소분석결과현시,질병상태(P=0.013)、질병진단도이식적시간(P=0.042)、예처리방안(P=0.046)、급성GVHD(P=0.022)、만성GVHD(P=0.002)여allo-HSCT후복발유관.Cox다인소회귀분석결과현시,질병상태(OR=2.58,95%CI위1.26～5.01)、질병진단도이식적시간(OR=1.98,95%CI위1.11～3.63)화만성GVHD(OR=3.74,95%CI위1.96～7.97)시allo-HSCT후복발적독립영향인소.결론 복발잉시allo-HSCT실패적수요원인,질병상태、질병진단도이식적시간이급무만성GVHD시이식후복발적주요위험인소.
Objective To explore the risk factors for relapse after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and the measures of prophylaxis and treatment.Methods We summarized the clinical data of 82 patients with hematologic malignancies who were treated in our hospital from August 2003to December 2008.Factors including age, sex, ABO blood group disparity of donor and recipient as well as the type of donor, status of disease, HLA-match, conditioning regimen, whether or not having developed acute GVHD and chronic GVHD, infusion number of CD34 + cells, relationship between CMV infection and relapse post-transplantation were considered and analyzed.Results Single factor analysis indicated that there were five independent risk factors related with the disease relapse ( P ＜ 0.05 ), including status of disease, time of diagnosis to transplantation, acute graft versus host disease (aGVHD), conditioning regimen, and chronic graft versus host disease (cGVHD).Simultaneously, the type of donor was a substantial factor (P ＜ 0.01 ), determined by multi-factor Cox regression analysis.Cox regression analysis determined that disease status ( OR = 2.58, 95% CI 1.26-5.01, P = 0.01 ), time from diagnosis to treatment ( OR = 1.98, 95% CI 1.11-3.63, P = 0.025 ) and cGVHD ( OR = 3.74, 95% CI 1.96-7.97,P ＜0.001 ) were major factors for relapse of the patients who had undergone transplantation.Conclusions Relapse remains the primary cause of failure after allo-HSCT.Status of disease, time from diagnosis to treatment and not cGVHD are the major risk factors.Effective prevention and treatment of relapse after engraftment can improve the efficacy of HSCT.
