与治疗相关的骨髓瘤发病风险的性别差异
Melissa A Richard1, Chengcheng Yan2, Yanjun Chen2
1Baylor College of Medicine, Houston, TX.
概括
干细胞中的克隆造血 (CH) 突变增加了淋巴瘤治疗后与治疗相关的骨髓瘤 (t-MN) 风险,特别是在男性中. 需要进行进一步的研究,以了解CH进展到t-MN的基于性别的差异.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 遗传学 遗传学 是一个
背景情况:
- 与治疗相关的骨髓瘤 (t-MN) 是针对非霍奇金淋巴瘤 (NHL) 自主干细胞移植后的一种严重并发症.
- 以前的研究表明,外周血液干细胞 (PBSC) 中的克隆性血液形成 (CH) 与t-MN风险之间存在联系,但缺乏足够的力量来分析特定的患者群体.
研究的目的:
- 调查PBSC中CH突变与NHL患者在自身移植后发展t-MN的风险之间的关联.
- 检查与CH相关的t-MN风险的潜在基于性别的差异.
主要方法:
- 984名NHL患者进行了自主PBSC移植的回顾性队列研究.
- 向DNA测序以检测PBSC中的CH突变.
- 细灰回归模型评估CH突变负担与t-MN风险之间的关联,调整为共变量.
主要成果:
- 在37.2%的患者中检测到CH;60人发展了t-MN.
- 两种或更多CH突变的存在显著增加了t-MN风险 (aHR,2.10;P=.029).
- 男人中CH与较高的t-MN风险相关 (aHR,1.83),而不是女性 (aHR,0.56);8年t-MN发病率在男性中CH (12.4%) 与女性中CH (3.6%) 较高.
结论:
- 在PBSC中的CH突变是男性NHL患者移植后t-MN的危险因素.
- 在女性患者中,CH和t-MN风险之间的关联并不显著.
- 需要进一步研究CH向t-MN进展的性别差异背后的生物机制.
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