移植后的循环胺与细菌感染的增加有关
Celalettin Ustun1, Min Chen2, Soyoung Kim2,3
1Division of Hematology/Oncology/Cell Therapy, Rush University, Chicago, IL, USA. Celalettin_Ustun@rush.edu.
Bone marrow transplantation
|October 31, 2023
概括
移植后的环胺 (PTCy) 增加了血液细胞移植 (HCT) 后的细菌感染. 在接受PTCy的患者中,仔细监测感染是至关重要的,因为感染与高死亡率有关,无论GVHD预防措施如何.
科学领域:
- 血造细胞移植 (HCT) 的方法
- 免疫抑制是一种免疫抑制.
- 传染性疾病 传染性疾病
背景情况:
- 移植后循环胺 (PTCy) 是一种常见的策略,用于预防输血细胞移植 (HCT) 中的移植与宿主疾病 (GVHD).
- 人们对与PTCy使用相关的感染风险增加存在担忧.
研究的目的:
- 评估基于PTCy的与基于氨酸抑制剂 (CNI) 的GVHD预防的HCT后细菌感染的发生率.
- 在不同的GVHD预防策略中评估细菌感染对移植相关死亡率 (TRM) 的影响.
主要方法:
- 对患者 (≥2年) 的回顾性分析,这些患者接受了针对急性白血病或骨髓质疏松症综合征的异形或匹配的兄弟捐赠者HCT.
- 患者接受了基于 PTCy 或基于 CNI 的 GVHD 预防.
- 细菌感染和TRM的发病率在各组之间进行了比较.
主要成果:
- 接受PTCy的患者 (与PTCy [HaploCy]相同的HCT和PTCy [SibCy]的兄弟) 显示,与基于CNI的[SibCNI]预防 (46%和48%对35%,p <0.001) 的兄弟相比,在第180天,细菌感染的发生率显著更高.
- 细菌感染与所有组的TRM显著增加有关,包括HaploCy,SibCy和SibCNI队列.
- PTCy与细菌感染的增加有关,不论捐赠者类型如何.
结论:
- 移植后的循环胺与HCT后细菌感染的发病率较高有关.
- 细菌感染显著增加死亡风险,无论使用GVHD预防方法.
- 建议在HCT后接受PTCy的患者进行细菌感染的密切监测.
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