高剂量化疗和淋巴瘤自身干细胞移植后的心血管疾病:一项基于丹麦人口的研究
Joachim Baech1,2, Simon Husby3, Trine Trab3
1Department of Hematology, Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark.
British journal of haematology
|December 29, 2023
概括
高剂量化疗和自身干细胞移植 (HDT-ASCT) 在淋巴瘤患者中显著增加了充血性心力衰竭 (CHF) 风险. 长期监测对于管理这些心血管并发症至关重要.
科学领域:
- 在瘤学瘤学.
- 心脏病学 心脏病学
- 血液学 血液学 血液学
背景情况:
- 心血管疾病,特别是充血性心力衰竭 (CHF),是已知的Anthracyclines的并发症.
- 在高剂量化疗和自主干细胞移植 (HDT-ASCT) 后,针对侵袭性淋巴瘤的CHF的特定风险尚未得到充分确立.
- 随着T细胞疗法的出现,了解HDT-ASCT的长期并发症至关重要.
研究的目的:
- 为了研究长期患有充血性心力衰竭 (CHF) 的风险,在接受高剂量化疗和自主干细胞移植 (HDT-ASCT) 治疗的患者中治疗攻击性淋巴瘤.
- 为了确定HDT-ASCT后与CHF相关的风险因素.
- 为了比较HDT-ASCT患者和普通人群中CHF的发病率.
主要方法:
- 一项针对丹麦患者的队列研究,这些患者在2001年至2017年期间接受了HDT-ASCT治疗,以治疗侵略性淋巴瘤.
- 根据性别,出生年份和查尔森并发症评分,患者与一般人群相匹配1:5.
- 全国范围的注册表被用来捕捉心脏事件,随访时间中位数为7.6年.
主要成果:
- 在HDT-ASCT群体中,心血管衰竭的风险显著增加 (调整后危险比率[HR]=5.5).
- 在HDT-ASCT患者中,CHF的10年累积发病率为8.0%,在匹配的对照患者中为2.0% (p < 0.001).
- 冠状动脉炎的危险因素包括男性性别,≥2种疗法,高血压和累积的反环素剂量 (≥300 mg/m2).
结论:
- 在侵略性淋巴瘤患者中,HDT-ASCT显著增加了充血性心力衰竭 (CHF) 的长期风险.
- HDT-ASCT也与其他心脏病的风险增加有关.
- 这些发现对于评估HDT-ASCT与新疗法相比的益处风险概况至关重要.
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