降低移植后的环胺剂量与外周血液干细胞平分异性移植中的抗细胞球蛋白
Rémy Duléry1,2, Florent Malard3,4, Eolia Brissot3,4
1Department of Clinical Hematology and Cellular Therapy, Sorbonne University, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France. remy.dulery@aphp.fr.
Bone marrow transplantation
|August 18, 2023
概括
将移植后的循环胺 (PT-Cy) 剂量降低到70 mg/kg,对于接受单一血型细胞移植 (HCT) 的老年人或心脏病患者来说是安全的. 这种剂量减少可以改善恢复和生存,同时降低毒性风险.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 移植后循环胺 (PT-Cy) 对于移植对宿主疾病 (GVHD) 预防在单一血型细胞移植 (HCT) 中至关重要.
- 标准PT-Cy剂量可能会引起毒性,特别是在老年患者或患有心脏并发症的患者中.
研究的目的:
- 为了比较降低剂量 (70毫克/公斤) 与标准剂量 (100毫克/公斤) PT-Cy 在特定 HCT 患者群体中的结果.
- 评估降剂PT-Cy在老年患者 (≥65岁) 和心脏病患者的安全性和有效性.
主要方法:
- 连续治疗血性恶性瘤患者的回顾性分析,这些患者接受了与血相同的HCT.
- 患者接受了外周血液干细胞 (PBSCs) 与基于甲酸的调节剂和低剂量的抗甲基细胞球蛋白.
- 在接受70 mg/kgPT-Cy (n=33) 和100 mg/kgPT-Cy (n=25) 的患者之间进行比较.
主要成果:
- 降低PT-Cy剂量并没有增加GVHD风险.
- 使用70mg/kg剂量观察到更快的中性粒细胞和血小板恢复.
- 降低剂量组中的细菌病 (38% vs. 72%) 和心脏并发症 (12% vs. 44%) 的发生率较低.
- 较高的2年无GVHD,无复发的生存率 (GRFS) 与减少的PT-Cy (60%对33%).
结论:
- 将PT-Cy降低到70mg/kg对于老年患者和经过单元同型HCT的心脏并发症患者来说是一个安全有效的策略.
- 较低的PT-Cy剂量与血液恢复的改善,毒性降低和GRFS的增强有关.
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