双向ABO不匹配与血液造血干细胞移植的高死亡率有关:来自单一中心实验的见解
Sidika Gülkan Özkan1, Ali Kimiaei1, Seyedehtina Safaei1
1Hematology, Bahçeşehir University, Istanbul, TUR.
Cureus
|March 27, 2024
概括
ABO不相容的造血干细胞移植 (HSCT) 显示中性粒细胞和血小板的移植时间相似. 然而,双向ABO不匹配会增加死亡风险,而非同源性HSCT (allo-HSCT) 中的主要ABO不匹配会增加死亡风险.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 移植医学 移植医学
背景情况:
- 造血干细胞移植 (HSCT) 为各种疾病提供了新的治疗途径.
- 在全基性HSCT (allo-HSCT) 中的ABO不兼容性带来了挑战,并影响了临床结果.
- 了解ABO不匹配效应对于优化HSCT成功至关重要.
研究的目的:
- 分析接受ABO不相容的HSCT的患者的生存结果.
- 为了评估纯红细胞无形成症 (PRCA) 的发生率,ABO后不兼容的HSCT.
- 在allo-HSCT中比较主要和双向ABO不匹配之间的结果.
主要方法:
- 对接受了ABO不兼容的HSCT的20名患者的回顾性分析.
- 收集患者特征,移植细节和随访数据.
- 审查调节方案和移植与宿主疾病 (GVHD) 预防策略.
主要成果:
- 中性粒细胞和血小板移植的持续时间在主要和双向ABO不匹配之间没有显著差异.
- 纯红细胞无形成症 (PRCA) 发生在20%的严重不匹配的患者中,对博雷佐米布反应良好.
- 双向ABO不匹配与3.57倍的死亡风险增加有关 (HR:0.28;p<0.05) 与主要不匹配相比.
结论:
- ABO不匹配 (主要或双向) 不显著影响中性粒细胞和血小板移植的持续时间在 allo-HSCT.
- 双向ABO不匹配与明显更高的死亡率有关,这表明整体存活率的预后不利.
- ABO不相容可能不是血液恢复的主要决定因素,但会影响alo-HSCT的长期存活率.
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