在儿童的移植失败后进行第二次异构造血细胞移植
Eun Sang Yi1, Hee Young Ju2, Ji Won Lee2
1Department of Pediatrics, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
Journal of Korean medical science
|March 18, 2025
概括
在移植失败 (GF) 的异构造血细胞移植 (allo-HCT) 之后的救援移植可以减少与治疗相关的死亡率. 然而,整体存活率仍然低于最佳水平,这凸显了对这些患者感染控制的关键需求.
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:
- 移植失败 (GF) 是异构造血型细胞移植 (allo-HCT) 后的一个重大并发症.
- 二次移植是一种公认的治疗策略,用于治疗移植失败.
研究的目的:
- 评估在初始alo-HCT.CT后出现移植失败的患者的救援移植的特征和结果.
- 分析成功移植对第二次HCT患者的存活率和死亡率的影响.
主要方法:
- 在1998年至2020年期间,对23名患者进行了第二次GFHCT的回顾性分析.
- 评估移植后的移植率,整体存活率 (OS) 和与治疗相关的死亡率 (TRM).
主要成果:
- 在救援移植后的52.2%的患者中,成功实现了中性粒细胞移植.
- 与移植失败患者相比,成功移植的患者表现出更好的生存状况 (41.7%) 和显著较低的TRM (33.3%) 的趋势.
- 在整个研究人群中,感染是主要的死亡原因 (n=12).
结论:
- 通过减少TRM,第二次allo-HCT后的成功植入改善了结果,但整体存活仍然是一个挑战.
- 有效管理传染性并发症对于改善接受救援移植的GF患者的存活率至关重要.
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