骨髓纤维化全源干细胞移植 - 一个回顾性单中心研究
Dharma Choudhary1, Divya Doval1, Vipin Khandelwal1
1Department of Hemato-oncology and Bone marrow transplantation, BLK Superspeciality Hospital, India.
Blood cell therapy
|June 16, 2023
概括
异构干细胞移植为髓纤维化提供治疗潜力,但存在风险. 这项研究发现60%的存活率,败血症和移植与宿主疾病是主要的并发症,强调需要仔细选择患者.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 骨髓纤维化 (MF) 是一种具有挑战性的血液性恶性瘤,治疗选择有限.
- 全基性造血干细胞移植 (HSCT) 是MF唯一潜在的治愈治疗方法.
- 高血压治疗提供长期生存,但与与治疗相关的显著发病率和死亡率有关.
研究的目的:
- 为了评估与骨髓纤维化患者的异性HSCT的结果.
- 评估整体存活率 (OS),无病存活率 (DFS) 和移植后并发症.
- 确定接受HSCT的MF患者的风险因素和死亡原因.
主要方法:
- 对15名多发性纤维患者进行异构HSCT的观测后期研究.
- 使用了移植前的动态国际预后评分系统 (DIPSS) 和HCT特异性并发症指数 (HCT-CI) 评分.
- 主要终点:OS和DFS. 二级终点:急性/慢性移植对宿主疾病 (GvHD),移植失败 (GF) 和细胞巨核病毒 (CMV) 活性化.
主要成果:
- 总生存率 (OS) 和无疾病生存率 (DFS) 为60%,没有观察到复发.
- 27%的患者患有急性GvHD,27%患有慢性 (有限) GvHD.
- 非复发性死亡率 (NRM) 为40%,主要是由于败血症,其次是急性GvHD.
结论:
- 全基性HSCT可以在骨髓纤维化患者中实现良好的DFS和OS,特别是在减少毒性条件下.
- 对于具有高DIPSS分数的患者,应考虑进行该程序.
- 败血症成为该队列的主要死亡原因,这强调了HSCT后感染管理的重要性.
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