在资源有限的国家开发异构血造原始细胞移植服务:挑战和成果
Uzma R Mahar1, Bushra Ahsan1, Usman Ahmad1
1Medical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK.
Cureus
|October 9, 2023
概括
在低收入国家开发一种全基性造血原生细胞移植 (HPCT) 服务是可行的. 最初的30个HPCT实现了71.3%的总生存率,相当于国际标准.
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 移植医学
背景情况:
- 异构干细胞移植为血液学疾病提供了治疗方法.
- 建立一个全基性造血原生细胞移植 (HPCT) 单位需要大量的资源.
- 低中等收入国家的三级医疗癌症医院在开发此类服务时面临着独特的挑战.
研究的目的:
- 记录在低中等收入国家建立异性HPCT服务的经验.
- 介绍中心最初进行的30种异构HPCT手术的结果.
- 评估在资源有限的环境中开发先进的癌症治疗的可行性和有效性.
主要方法:
- 一项对患有血液性恶性瘤的成年患者 (≥18岁) 的回顾性观察性研究.
- 数据采集于2019年7月至2023年4月的Shaukat Khanum纪念癌症医院和研究中心.
- 移植类型的分析 (匹配的兄弟捐赠者与与单独的相关捐赠者) 和调节方案 (骨髓缩性与强度降低).
主要成果:
- 进行了30个全基性HPCT:24个来自匹配的兄弟捐赠者,6个来自与 haploidentical 相关的捐赠者.
- 随访时间中位数为12个月.
- 一年总生存率为71.3%,无病生存率为63.7%.
- 急性淋巴细胞白血病的一年无病生存率为51.5%,急性髓性白血病为78.7%.
结论:
- 尽管存在财务限制,但成功开发了一种全基性骨髓移植装置.
- 该服务为癌症患者提供潜在的治愈性,拯救生命的治疗.
- 移植结果与国际注册表可比,证明了在资源有限的环境中这种计划的可行性.
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