中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
2期
123-125
,共3页
牛晓敏%何慧清%周睿卿%许晓军
牛曉敏%何慧清%週睿卿%許曉軍
우효민%하혜청%주예경%허효군
白血病,髓样%造血干细胞移植%巨细胞病毒%复发
白血病,髓樣%造血榦細胞移植%巨細胞病毒%複髮
백혈병,수양%조혈간세포이식%거세포병독%복발
Leukemia,myeloid%Hematopoietic stem cell transplantation%Cytomegalovirus%Recurrence
目的 探讨急性髓系白血病(AML)患者异基因造血干细胞移植(allo-HSCT)后巨细胞病毒(CMV)感染对白血病复发的影响.方法 回顾性分析2005年1月至2014年1月中山大学附属中山医院血液内科接受allo-HSCT的62例AML患者(除外急性早幼粒细胞性白血病),观察患者移植后白血病复发与CMV感染及供受者临床特征的关系.结果 单因素分析显示,初诊时白细胞＞100×109/L、疾病高危、移植后环孢素浓度低于200 μg/L的患者复发率高,而移植后CMV阳性及慢性GVHD患者复发率低;Cox多因素分析显示,疾病高危(RR=3.296,95％ CI:1.274～8.530,P＝0.014)、无慢性GVHD(RR =0.167,95％ CI:0.042～0.668,P=0.011)及CMV阴性(RR＝0.285,95％CI:0.084 ～0.973,P=0.045)是移植后复发的独立危险因素.结论 AML患者allo-HSCT后CMV血症是影响复发的有利因素之一.
目的 探討急性髓繫白血病(AML)患者異基因造血榦細胞移植(allo-HSCT)後巨細胞病毒(CMV)感染對白血病複髮的影響.方法 迴顧性分析2005年1月至2014年1月中山大學附屬中山醫院血液內科接受allo-HSCT的62例AML患者(除外急性早幼粒細胞性白血病),觀察患者移植後白血病複髮與CMV感染及供受者臨床特徵的關繫.結果 單因素分析顯示,初診時白細胞＞100×109/L、疾病高危、移植後環孢素濃度低于200 μg/L的患者複髮率高,而移植後CMV暘性及慢性GVHD患者複髮率低;Cox多因素分析顯示,疾病高危(RR=3.296,95％ CI:1.274～8.530,P＝0.014)、無慢性GVHD(RR =0.167,95％ CI:0.042～0.668,P=0.011)及CMV陰性(RR＝0.285,95％CI:0.084 ～0.973,P=0.045)是移植後複髮的獨立危險因素.結論 AML患者allo-HSCT後CMV血癥是影響複髮的有利因素之一.
목적 탐토급성수계백혈병(AML)환자이기인조혈간세포이식(allo-HSCT)후거세포병독(CMV)감염대백혈병복발적영향.방법 회고성분석2005년1월지2014년1월중산대학부속중산의원혈액내과접수allo-HSCT적62례AML환자(제외급성조유립세포성백혈병),관찰환자이식후백혈병복발여CMV감염급공수자림상특정적관계.결과 단인소분석현시,초진시백세포＞100×109/L、질병고위、이식후배포소농도저우200 μg/L적환자복발솔고,이이식후CMV양성급만성GVHD환자복발솔저;Cox다인소분석현시,질병고위(RR=3.296,95％ CI:1.274～8.530,P＝0.014)、무만성GVHD(RR =0.167,95％ CI:0.042～0.668,P=0.011)급CMV음성(RR＝0.285,95％CI:0.084 ～0.973,P=0.045)시이식후복발적독립위험인소.결론 AML환자allo-HSCT후CMV혈증시영향복발적유리인소지일.
Objective To explore the relationship between cytomegalovirus (CMV) infection and risk factors for relapsing patients with acute myeloid leukemia(AML) (non-acute promyelocytic leukemia) after hematopoietic stem cell transplantation (HSCT).Methods A total of 62 allo-HSCT patients from January 2005 to January 2014 were enrolled and analyzed retrospectively.And the clinical characteristics of donors and recipients and post-transplantation relapse were recorded.Results Single factor analysis indicated that there were 5 risk factors correlated with disease relapse (P ＜0.05).Leucocytosis (＞ 100 × 109/L),high-risk AML and cyclosporine A concentration under 200 μg/L were correlated with high relapsing rates while CMV reaction and chronic graft versus host disease had a low relapsing rate.Cox regression analysis revealed that high-risk AML (RR =3.296,95％ CI:1.274-8.530,P =0.014),CMV negativity (RR =0.285,95 ％ CI:0.084-0.973,P =0.045) and non-chronic GVHD (RR =0.167,95 ％ CI:0.042-0.668,P =0.011) were major risk factors of relapse.Conclusion Human CMV viremia after allo-HSCT has a decreased relapsing risk in patients with AML.
