在为血液性恶性瘤移植外周血液造血细胞后,GVHD无复发的生存率
Deepesh P Lad1, Prashant Chhabra1, Kripa Shanker Kasudhan1
1Department of Clinical Hematology and Medical Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Blood cell therapy
|December 26, 2023
概括
在印度使用外周血液干细胞 (PBSC) 进行的血造细胞移植 (HCT) 在匹配的相关捐赠者 (MRD) 和单一 (haplo) 捐赠者之间显示了可比的结果. 这项研究发现了相似的移植对宿主疾病 (GVHD) 和生存率,鼓励缺乏MRD的患者使用Haplo-HCT.
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:
- 造血细胞移植 (HCT) 对血液性恶性瘤至关重要.
- 印度主要使用匹配的相关捐赠者 (MRD) 或同 (haplo) 捐赠者.
- 周围血液干细胞 (PBSC) 在印度常用,增加了移植对宿主疾病 (GVHD) 的风险.
研究的目的:
- 为了前性地比较MRD-HCT与Haplo-HCT在患有血液性恶性瘤的成年患者中的结果.
- 评估两种供体类型之间的移植与宿主疾病 (GVHD),复发和生存率.
主要方法:
- 2017-2021年的一项单中心前性研究包括41名MRD和33名哈普洛-HCT接受者.
- 针对GVHD的预防有所不同:用于MRD-HCT的环素 + 甲铁酸和用于 haplo-HCT的移植后环胺 (PTCy).
- 主要终点:GVHD无复发生存期 (GRFS),定义为没有严重急性/慢性GVHD,复发或死亡的时间.
主要成果:
- 在III-IV级急性GVHD (16%vs.27%),中度至重度慢性GVHD (58%vs.71%) 或一年的GRFS (53%vs.38%) 中没有显著差异.
- 复发发病率 (22% vs. 19%) 和非复发死亡率 (25% vs. 35%) 在MRD-HCT和Haplo-HCT之间也是可比的.
- 一年整体存活率没有显著差异 (60%对52%).
结论:
- 尽管在哈普洛-HCT中骨髓衰变条件的比率更高,但包括GRFS在内的结果与MRD-HCT相似.
- 对于缺乏MRD的患者来说,Haplo-HCT是一种可行的替代方案,提供类似的生存率和GVHD概况.
- 这些发现支持印度在血液恶性瘤中增加了哈普洛-HCT的利用率.
相关概念视频
01:22Bone Marrow Sampling and Transplants
333
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
333
01:19Multipotency of Hematopoietic Stem Cells
3.1K
The hematopoietic stem cells or HSCs are multipotent, meaning they can differentiate and give rise to all blood and immune cells. HSCs are maintained in the quiescent stage until an external stimulus initiates their differentiation. The multipotent HSCs exist as two heterogeneous populations, long-term repopulating cells (LTRC) and short-term repopulating cells (STRC). The two HSC populations have different surface markers or receptors and are classified based on quiescence and long-term...
3.1K