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跨越四十年的全源干细胞移植的纵向结果:一个单一中心的经验
Miguel Ángel Sanz1,2, Juan Montoro1,3,4, Aitana Balaguer-Roselló1,3
1Hematology Department, Hospital Universitari i Politècnic La Fe, València, Spain.
Bone marrow transplantation
|June 25, 2024
概括
血液造血干细胞移植 (HSCT) 结果在45年内显著改善,这是由于捐赠者选择和移植对宿主疾病 (GVHD) 预防的进步. 这些创新提高了移植患者的生存率,并减少了移植患者的并发症.
科学领域:
- 血液学 血液学 血液学
- 移植医学 移植医学
- 免疫学 免疫学 免疫学
背景情况:
- 造血干细胞移植 (HSCT) 自1978年以来已经显著发展.
- 早期的HSCT面临着有限活动和适度结果的挑战.
- 带血移植 (UCBT) 成为没有匹配的兄弟捐赠者患者的关键策略.
研究的目的:
- 评估45年 (1978-2022年) 的异构HSCT的长期结果和并发症.
- 确定关键的进展及其对患者生存和无事件生存的影响.
- 提供关于移植实践和个性化治疗方法不断变化的景观的见解.
主要方法:
- 追溯分析在一个机构接受HSCT的1707名患者.
- 在不同的时间段内检查移植活动,供体选择,调节方案和GVHD预防.
- 统计评估整体存活率,无事件存活率和无GVHD/无复发存活率.
主要成果:
- 从1988年开始,移植活动大幅增加,近年来 (2017-2022) 从UCBT转移到平分异构移植.
- 引入基于PTCY的GVHD预防和优化调节方案 (thiotepa,busulfan,fludarabine) 导致了显著的改善.
- 减少GVHD,非复发死亡率和复发率有助于提高生存指标.
结论:
- 全基性HSCT实践已经动态发展,导致显著改善患者的治疗结果.
- 在GVHD预防和供体选择的变化是推动这些积极趋势的关键因素.
- 在HSCT的持续创新对于推进个性化治疗策略和提高生存率至关重要.
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