在所有人群中减少慢性移植与宿主疾病的发生率
Paul A Carpenter1,2, Ted A Gooley1,3, Julie Boiko1,2
1Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA.
Blood advances
|August 21, 2024
概括
需要免疫抑制的慢性移植对宿主疾病 (cGVHD) 自2005年以来稳步下降. 这一趋势表明血造细胞移植 (HCT) 结果得到改善,强调在cGVHD研究中需要当代控制.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 慢性移植与宿主疾病 (cGVHD) 仍然是血液细胞移植 (HCT) 后的重大并发症.
- 自2005年以来,弗雷德·哈森癌症中心观察到cGVHD发病率显著下降.
研究的目的:
- 随着时间的推移,调查cGVHD需要全身免疫抑制 (cGVHD-IS) 的趋势.
- 分析HCT日期与发展cGVHD-IS的风险之间的关联.
主要方法:
- 在2005年至2019年间,对3066名接受HCT的幸存者进行了回顾性分析.
- 使用考克斯回归模型来评估HCT日期对cGVHD-IS风险的影响.
- 分析包括各种患者和移植相关因素的未调整和调整模型.
主要成果:
- 在两年内,cGVHD-IS的概率从45-52% (2005-2007) 显著下降到2017年约26%,从45-52% (2005-2007) 显著下降到2017年约26%.
- 在儿科幸存者中也观察到类似的下降,自2013年以来的概率低于10%.
- 每增加5年的HCT日期都与cGVHD危险降低27%有关,即使经过对混因子进行调整.
结论:
- 观察到cGVHD-IS的下降是一个显著的趋势,不能完全由患者人口统计学或HCT策略的变化来解释.
- 这一发现凸显了在评估cGVHD预防策略的研究中使用同期对照组的重要性.
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