具有双源细胞和移植后环胺基双源细胞的哈普洛同一干细胞移植
Ana Marcela Rojas Fonseca-Hial1,2, Katya Parisio2, Jose Salvador Rodrigues de Oliveira1,2
1Transplante de Medula Ossea Section, Federal University of Sao Paulo-UNIFESP, Sao Paulo, Brazil.
Cancer medicine
|February 1, 2025
概括
使用双干细胞来源 (DSC) 和移植后环胺 (PT-Cy) 的哈普洛同一性造血细胞移植 (Hid-HCT) 是对良性和恶性疾病的安全有效治疗选择. 这种方法显示出有希望的生存率和可管理的并发症,为需要移植的患者提供了可行的替代方案.
科学领域:
- 血液学 血液学 血液学
- 移植免疫学 移植免疫学
- 在瘤学瘤学.
背景情况:
- 双干细胞来源 (DSC),结合外围血液干细胞疏散 (PBSC) 和手术骨髓 (BM),在某些地区被用于单独的造血细胞移植 (Hid-HCT).
- 巴尔的摩小组已经建立了使用移植后环胺 (PT-Cy) 和减少强度条件 (RIC) 的Hid-HCT的经验,使用BM作为干细胞来源.
研究的目的:
- 评估Hid-HCT使用DSC与PT-Cy和RIC或骨髓缩条件 (MAC) 的安全性和有效性.
- 评估包括生存,移植与宿主疾病 (GVHD) 和良性和恶性疾病患者的复发率在内的结果.
主要方法:
- 进行了对64个与DSC和PT-Cy有关的Hid-HCT病例的回顾性分析.
- 患者接受了RIC (n=57) 或MAC (n=7) 治疗方案,随访时间中位数为23.3个月.
主要成果:
- 所有患者的2年整体存活率为54.7%,良性疾病为73.3%,恶性疾病为49% (超过第一次缓解).
- 100天III-IV级急性GVHD的累积发病率为12.3%,而2年中度/重度慢性GVHD的累积发病率为21.1%.
- 造血细胞移植特异性并发症指数 (HCT-CI) 和通过异位收集的CD34+细胞数量是生存和无病生存 (DFS) 的重要因素.
结论:
- 使用PT-Cy,DSC和RIC的Hid-HCT代表了良性和恶性疾病患者的安全治疗策略.
- 这项研究强调了HCT-CI和干细胞剂量在预测Hid-HCT.结果方面的重要性.
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