在所有基血型造血干细胞移植后的儿童肺部并发症
Hannah Walker1,2,3, Joanne Abbotsford4, Gabrielle M Haeusler2,3,5,6,7,8
1Children's Cancer Centre Royal Children's Hospital Parkville VIC Australia.
儿科造血干细胞移植 (HCT) 后肺部并发症很常见,显著增加死亡风险. 识别有风险的儿童和改善治疗方法对于更好的结果至关重要.
科学领域:
- 儿科血液学 儿科血液学
- 肺部病理学 肺部病理学
- 移植免疫学 移植免疫学
背景情况:
- 造血干细胞移植 (HCT) 对儿科疾病具有治愈潜力,但存在重大风险,特别是肺部并发症.
- 在HCT后的肺部并发症是儿童死亡的重要原因.
研究的目的:
- 确定接受HCT的澳大利亚儿童肺部并发症的发生率和负担.
- 确定与HCT后肺部并发症发展相关的风险因素.
主要方法:
- 两家澳大利亚儿科移植中心的医疗记录的回顾性审查.
- 对人口统计,HCT特征和肺部并发症的分析.
- 使用相对风险比率和生存率分析来确定风险因素和死亡风险.
主要成果:
- 肺部并发症发生在48%的儿科HCT接受者中.
- 感染性并发症最常见 (55%),其次是非感染性并发症 (18%).
- 风险因素包括MPAL诊断,匹配的无关或带血干细胞来源,以及先前存在的肺部疾病. 在HCT后的肺部并发症显著增加了死亡风险 (HR 3.9).
结论:
- 肺部并发症仍然是HCT后儿童的常见和严重问题,对死亡率有很大影响.
- 需要加强策略,以在移植前识别有风险的儿科患者.
- 改善治疗方法是必要的,以管理肺部疾病在这个脆弱的人群.
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