在儿童的全源造血干细胞移植后,调节强度和身高增长之间的关联
Suguru Uemura1, Daiichiro Hasegawa1, Kenji Kishimoto1
1Department of Hematology and Oncology, Kobe Children's Hospital, Kobe, Japan.
Cancer medicine
|July 12, 2023
概括
接受全源造血干细胞移植 (allo-HSCT) 的小儿病患面临更高的矮身风险. 降低强度调节 (RIC) 显示对移植后身高增长的影响较小.
科学领域:
- 儿科血液学 儿科血液学
- 在瘤学瘤学.
- 移植医学 移植医学
背景情况:
- 全源性造血干细胞移植 (allo-HSCT) 是儿童恶性疾病的关键治疗方法.
- 条件调节方案,强度各异,先于alo-HSCT,可以影响患者的长期结果.
- 长度增长是alo-HSCT的儿科幸存者的一个重要问题.
研究的目的:
- 为了研究调节疗程强度和儿科患者的身高增长之间的关联后allo-HSCT.
- 为了比较接受骨髓衰变调节 (MAC) 和减少强度调节 (RIC) 的患者之间的身高标准偏差 (SDS) 评分.
- 为了确定儿童在alo-HSCT后矮身的风险因素.
主要方法:
- 对89名接受初始alo-HSCT的儿科患者的临床记录进行了回顾性审查.
- 使用日本儿科内分泌学会图表来计算SDS的高度测量的标准化.
- 根据照射和布苏尔剂量,定义骨髓衰变条件 (MAC) 和强度降低条件 (RIC).
主要成果:
- 在MAC和RIC组之间,在合HSCT后2年和3年观察到身高SDS的显著差异.
- 接受MAC治疗的患者与接受RIC治疗的患者相比,在2年和3年内,SDS的高度显著降低.
- 多变量分析表明,在allo-HSCT后3年,MAC显著增加了矮身风险 (身高SDS<-2.0).
结论:
- 调节疗程的强度是影响小儿科患者在alo-HSCT后矮身的潜在因素.
- 与减少强度调节相比,肌肉衰变调节与较高的身高增长受损风险有关.
- 进一步的研究可能会为减轻儿科all-HSCT幸存者的生长障碍的策略提供信息.
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