在异性干细胞移植后的EASIX-1年和晚期死亡率
Lambros Kordelas1, Tobias Terzer2, Ted Gooley3,4
1Department of Bone Marrow Transplantation, West German Cancer Centre, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Blood advances
|July 21, 2023
概括
在异性干细胞移植 (allo-SCT) 一年后评估的内皮激活和压力指数 (EASIX) 预测了幸存者的晚期非复发死亡率 (NRM). 这种经过验证的EASIX-1年评分可以识别高风险患者,以便加强监测和干预.
科学领域:
- 血液学 血液学 血液学
- 移植免疫学 移植免疫学
- 在瘤学瘤学.
背景情况:
- 同源干细胞移植 (allo-SCT) 幸存者面临非复发性死亡率 (NRM) 的重大风险,并且缺乏晚期结果的预测标记.
- 内皮激活和压力指数 (EASIX) 是已确立的并发症和NRM后合金-SCT的早期预测指标.
研究的目的:
- 调查EASIX评分是否可以预测晚期NRM,该评分在无疾病幸存者中评估allo-SCT后一年,可以预测晚期NRM.
- 在独立患者队列中验证EASIX-1year作为总生存期 (OS) 和NRM的预测标志物.
主要方法:
- 对两个独立的队列 (n=610培训,n=852验证) 的回顾性分析,这些是1年后没有复发的allo-SCT幸存者.
- 移植后一年EASIX分数的计算和与包括OS,NRM和复发在内的临床结果的相关性.
- 在培训队伍中分析血清内皮和炎症标志物,以确定与EASIX-1year的关联.
主要成果:
- 在两个队列中,EASIX评估的一年后的SCT (EASIX-1year) 与OS和NRM显著相关,但没有复发风险.
- 在单变量和多变量考克斯回归分析中,EASIX-1year证明了预测价值,并通过Brier分数和c指数进行了验证.
- EASIX-1年预测的结果独立于慢性移植对宿主疾病 (GVHD) 和先前存在的并发症. 感染和心血管并发症是NRM的主要原因.
结论:
- EASIX-1year是NRM晚期和alo-SCT幸存者的整体存活率的第一个验证的预测器.
- 通过EASIX-1year确定为高风险的患者可能受益于加强监测和预防策略.
- EASIX-1year与sCD141和互白素-18等特定标志物相关,表明潜在的内皮和炎症通路.
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