中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2013年
12期
1020-1023
,共4页
燕法红%王玫%黄勇%姜尔烈%马巧玲%魏嘉璘%庞爱明%张荣莉%冯四洲
燕法紅%王玫%黃勇%薑爾烈%馬巧玲%魏嘉璘%龐愛明%張榮莉%馮四洲
연법홍%왕매%황용%강이렬%마교령%위가린%방애명%장영리%풍사주
造血干细胞移植,异基因%移植物抗宿主病%危险因素
造血榦細胞移植,異基因%移植物抗宿主病%危險因素
조혈간세포이식,이기인%이식물항숙주병%위험인소
Hematopoietic stem cell transplantation,allogeneic%Graft vs host disease%Risk factors
目的 探讨异基因造血干细胞移植(allo-HSCT)后肠道急性移植物抗宿主病(aGVHD)发生的危险因素.方法 回顾性分析2004年1月至2012年9月进行allo-HSCT的533例(534例次)患者临床资料,应用Logistic回归分析供受者人类白细胞抗原(HLA)配型是否相合、患者年龄、供者年龄、供受者性别关系、供受者亲缘关系、干细胞来源、预处理含或不含全身放射治疗(TBI)、HLA位点等因素与不同程度肠道aGVHD的关系.结果 123例(23.0％)患者发生肠道aGVHD,其中Ⅰ度86例(16.1％),Ⅱ～Ⅳ度37例(6.9％).多因素分析显示供受者HLA配型不合(OR=2.519,P=0.002)、供者年龄增大(OR=1.034,P=0.002)、女性供者男性受者(OR=1.840,P=0.008)是发生肠道aGVHD的危险因素,HLA-B38(OR=0.256,P=0.032)是其保护因素;供受者HLA配型不合(OR=2.799,P=0.011)、供者年龄增大(OR=1.045,P=0.012)、HLA-A1(OR=4.157,P=0.002)、HLA-A30(OR=3.143,P=0.005)是发生Ⅱ～Ⅳ度肠道aGVHD的危险因素.结论 肠道aGVHD的发生及严重程度与供受者HLA配型是否相合、供者年龄、供受者性别关系及某些HLA位点相关.
目的 探討異基因造血榦細胞移植(allo-HSCT)後腸道急性移植物抗宿主病(aGVHD)髮生的危險因素.方法 迴顧性分析2004年1月至2012年9月進行allo-HSCT的533例(534例次)患者臨床資料,應用Logistic迴歸分析供受者人類白細胞抗原(HLA)配型是否相閤、患者年齡、供者年齡、供受者性彆關繫、供受者親緣關繫、榦細胞來源、預處理含或不含全身放射治療(TBI)、HLA位點等因素與不同程度腸道aGVHD的關繫.結果 123例(23.0％)患者髮生腸道aGVHD,其中Ⅰ度86例(16.1％),Ⅱ～Ⅳ度37例(6.9％).多因素分析顯示供受者HLA配型不閤(OR=2.519,P=0.002)、供者年齡增大(OR=1.034,P=0.002)、女性供者男性受者(OR=1.840,P=0.008)是髮生腸道aGVHD的危險因素,HLA-B38(OR=0.256,P=0.032)是其保護因素;供受者HLA配型不閤(OR=2.799,P=0.011)、供者年齡增大(OR=1.045,P=0.012)、HLA-A1(OR=4.157,P=0.002)、HLA-A30(OR=3.143,P=0.005)是髮生Ⅱ～Ⅳ度腸道aGVHD的危險因素.結論 腸道aGVHD的髮生及嚴重程度與供受者HLA配型是否相閤、供者年齡、供受者性彆關繫及某些HLA位點相關.
목적 탐토이기인조혈간세포이식(allo-HSCT)후장도급성이식물항숙주병(aGVHD)발생적위험인소.방법 회고성분석2004년1월지2012년9월진행allo-HSCT적533례(534례차)환자림상자료,응용Logistic회귀분석공수자인류백세포항원(HLA)배형시부상합、환자년령、공자년령、공수자성별관계、공수자친연관계、간세포래원、예처리함혹불함전신방사치료(TBI)、HLA위점등인소여불동정도장도aGVHD적관계.결과 123례(23.0％)환자발생장도aGVHD,기중Ⅰ도86례(16.1％),Ⅱ～Ⅳ도37례(6.9％).다인소분석현시공수자HLA배형불합(OR=2.519,P=0.002)、공자년령증대(OR=1.034,P=0.002)、녀성공자남성수자(OR=1.840,P=0.008)시발생장도aGVHD적위험인소,HLA-B38(OR=0.256,P=0.032)시기보호인소;공수자HLA배형불합(OR=2.799,P=0.011)、공자년령증대(OR=1.045,P=0.012)、HLA-A1(OR=4.157,P=0.002)、HLA-A30(OR=3.143,P=0.005)시발생Ⅱ～Ⅳ도장도aGVHD적위험인소.결론 장도aGVHD적발생급엄중정도여공수자HLA배형시부상합、공자년령、공수자성별관계급모사HLA위점상관.
Objective To investigate the risk factors of intestinal acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods The clinical data of 534 cases of 533 patients undergoing allo-HSCT during Jan 2004 and Sep 2012 were retrospectively analyzed.The effects of donor-recipient HLA mismatching,recipient age,donor age,donor-recipient sex combination,donor-recipient relationship,HSC source,conditioning regimen with or without total body irradiation (TBI) and HLA loci on intestinal aGVHD with different severity were analyzed by Logistic regression.Results Intestinal aGVHD occurred in 123 (23.0％) cases,with 86 (16.1％) cases of stage 1 intestinal aGVHD (16.1％)and 37 (6.9％) cases of stage 2 to 4 intestinal aGVHD.Multivariate analysis showed that donor-recipient HLA mismatching (OR=2.519,P=0.002),increasing donor age (OR=1.034,P=0.003),female donor for male recipient (OR=1.855,P=0.007) were risk factors for intestinal aGVHD,HLA-B38 (OR=0.256,P=0.032) was its protective factor.Donor-recipient HLA mismatching (OR=2.799,P=0.011),increasing donor age (OR=1.045,P=0.012),HLA-A1 (OR=4.157,P=0.002),A30 (OR=3.143,P=0.005) were risk factors for stage 2 to 4 intestinal aGVHD.Conclusions Occurrence of intestinal aGVHD and its severity are associated with donor-recipient HLA mismatching,donor age,donor-recipient sex relationships and some HLA loci.
