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溶性血栓蛋白与儿科血造干细胞移植后的内皮功能障碍综合征有关

Denise Elbæk Horan^1,2, Pär I Johansson^3,4, Marianne Ifversen¹

¹Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Pediatric blood & cancer

|March 22, 2025

概括

在儿科血造干细胞移植 (HSCT) 后,高可溶性血栓模块素 (sTM) 水平表明内皮功能障碍综合征如SOS,CLS和严重aGvHD的风险增加. sTM可能有助于早期诊断和治疗这些疾病.

科学领域:

血液学血液学血液学
儿科瘤学儿科瘤学
移植免疫学移植免疫学

背景情况:

异质造血干细胞移植 (HSCT) 被内皮功能障碍综合征复杂化,包括鼻状阻塞综合征 (SOS),毛细血管泄漏综合征 (CLS) 和严重急性移植对宿主疾病 (aGvHD).
溶性血栓模块素 (sTM) 是内皮损伤的标志物,对于理解这些移植后并发症至关重要.

研究的目的:

研究可溶性血栓模块素 (sTM) 水平与儿科HSCT后的内皮功能障碍综合征之间的关联.
确定sTM作为这些不良事件的早期诊断标记物的临床实用性.

主要方法:

在113名接受HSCT的儿童中测量了血STM水平,从预先调节到移植后的+180天.
进行了统计分析,以将sTM水平与SOS,CLS和aGvHD的发病率和严重程度相关联.

主要成果:

在调节后,sTM水平显著增加,特别是在以busulfan为基础的疗法中,并在整个研究期间保持升高.
在HSCT后的+7日和+14日升高的sTM水平与SOS的发展有显著的关联.
在+14天的高sTM水平与严重aGvHD (III-IV级) 相相关,在+7天的高sTM水平在患有CLS的儿童中观察到.

结论:

在HSCT后早期升高的sTM水平与儿科患者的SOS,CLS和严重的aGvHD的发展有关.
条件诱导的内皮损伤和前血栓状况与这些综合征的发病有关.
在HSCT后,sTM显示出作为一种有价值的生物标志物的潜力,用于早期检测和管理HSCT后内皮损伤综合征.

关键词:

急性移植对宿主疾病 (aGvHD)内皮质功能障碍在内皮质功能障碍儿科造血干细胞移植儿科造血干细胞移植阴侧阻塞综合征 (SOS) 是一种可溶性血栓模块素 (sTM) 是一种可溶性血栓模块素.

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