补充激活和血管并发症后儿科全源性造血干细胞移植
Lilli Leimi1, Kim Vettenranta2, Seppo Meri3,4
1University of Helsinki, Helsinki University Hospital, Children´s Hospital, and Pediatric Research Center, Helsinki, Finland. lilli.leimi@helsinki.fi.
Scientific reports
|February 27, 2025
概括
儿科造血干细胞移植 (HSCT) 涉及显著的毒性. 补充激活,特别是终端补充,与严重的HSCT相关的血栓性微血管病变 (TMA) 有关.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 儿科医学 儿科医学
背景情况:
- 与治疗相关的毒性是儿科造血干细胞移植 (HSCT) 的一个主要挑战.
- 了解补充系统在HSCT并发症中的作用对于改善患者的治疗结果至关重要.
研究的目的:
- 调查在儿科HSCT期间和之后补充系统的激活.
- 分析补充激活和急性不良事件,包括血管并发症之间的关系.
主要方法:
- 对42名儿科HSCT患者进行前性单中心研究.
- 血C3a和SC5b-9水平在移植前和移植后被测量.
- 监测和分析了急性不良事件和血管并发症.
主要成果:
- 在HSCT后的100天内,不良事件 (92.9%) 和严重事件 (54.8%) 的高发病率.
- 毛细血管泄漏综合征 (CLS),静脉封闭性疾病/阴侧阻塞综合征 (VOD/SOS) 或血栓微血管病变 (TMA) 在9.5%的患者中发生.
- 补充激活,以增加的C3a表示,发生在移植前期.
- 在10名患者中观察到SC5b-9水平升高,但与不良事件没有明确的相关性,除了一个严重的TMA病例外.
结论:
- 终端补充激活似乎与临床上显著的HSCT相关的TMA特别相关.
- 需要进一步的研究来阐明补充激活在其他HSCT毒性的精确作用.
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