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顺序相同的干细胞移植:一半的比赛但更多的希望!-来自印度西部的单一中心经验

Akanksha Garg¹, Maharshi Trivedi¹, Aishwarya Raj¹

¹Department of Medical and Pediatric Oncology, Gujarat Cancer and Research Institute, Ahmedabad, India.

Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion

|July 16, 2024

概括

在印度,使用移植后环胺平台的平相同干细胞移植 (HaploSCT) 显示出有前途的结果. 这种具有成本效益的方法为缺乏匹配捐赠者的患者提供了可行的治疗选择,并取得了与国际中心可比的结果.

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:

哈普洛同一干细胞移植 (HaploSCT) 在全球范围内激增,这是由于移植后环胺 (PTCy) 协议的进步.
关于印度的HaploSCT结果的数据有限,这凸显了对区域数据的需求.
印度政府的医疗保健计划增加了获得补贴的移植手术的机会.

研究的目的:

评估印度一家中心的平平相同干细胞移植 (HaploSCT) 的临床结果.
在资源有限的环境中,评估基于移植后环胺 (PTCy) 的平台的可行性和有效性.
分析接受HaploSCT的印度患者的生存率,移植和移植与宿主疾病 (GVHD) 发生率.

主要方法:

在2015年1月至2022年11月期间接受HaploSCT的50名患者的回顾性分析.
使用移植后的环胺 (PTCy) 与mycophenolate mofetil和calcineurin抑制剂用于GVHD预防.
调节方案主要涉及Fludarabine,Busulphan和Cyclophosphamide;外周血液干细胞被输血.

主要成果:

在70%的患者中观察到成功的移植,中性粒细胞和血小板移植时间的中位数分别为16天和18天.
急性GVHD发生在28%的患者中,慢性GVHD发生在6%的患者中.
两年总生存率为43%,平均生存期为17个月;在随访时,42%的患者还活着.

结论:

带有PTCy平台的HaploSCT是印度没有匹配捐赠者的患者的可行和具有成本效益的治疗方法.
该研究使用仿制药取得了可接受的结果,证明了负担能力和可访问性.
虽然TRM的发病率相当,但多药耐药性细菌感染仍然是发展中国家面临的重大挑战.

关键词:

在GVHD中,GVHD是指GVHD.这是一个HaploSCTT.移植后的循环胺基.

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