在骨髓纤维化症中移植血液造血原始体
Gilberto Barranco-Lampón1,2, Raúl Martínez-Castro3, Luara Arana-Luna4
1Servicio de Hematología, Hospital General de México, Ciudad de México, México.
概括
这项研究提供了专家共识建议,用于原发性髓纤维化 (PMF) 的全源干细胞移植 (allo-SCT). 关键领域包括患者选择,供体选择和管理并发症以优化治疗结果.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 移植医学 移植医学
背景情况:
- 初级骨髓纤维化 (PMF) 是一种由骨髓纤维化为特征的骨髓扩散性瘤.
- 全基性干细胞移植 (allo-SCT) 是PMF的潜在治疗方法,但最佳管理策略需要明确的指导方针.
研究的目的:
- 制定基于证据的建议,用于PMF患者的allo-SCT的管理.
- 为患者和供体选择,移植前和移植后的护理以及复发管理提供指导.
主要方法:
- 一个系统的文献综述1999年至2015年间发表的文章.
- 一个德尔菲过程,涉及来自欧洲白血病网络和欧洲血液和骨髓移植小组的23名欧洲专家.
主要成果:
- 为患者选择 (中等-2/高风险,年龄70岁以下;中等-1风险与特定标准),供体选择 (HLA匹配或非相同的供体) 和干细胞来源 (周边血液) 制定了建议.
- 这些指导方针涉及移植前的管理,调节方案 (最佳强度尚未定义) 和移植后的护理,包括复发预防策略 (例如,供体淋巴细胞输液).
结论:
- 基于共识的建议是为了优化PMF中的allo-SCT而生成的.
- 该研究确定了PMF的allo-SCT管理中的未满足的临床需求,突出了未来研究和临床重点领域.
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