随后的癌症在非骨髓衰变条件下对全原性造血细胞移植进行了非骨髓衰变的调节
Phuong Vo1,2, Kevin Ng3,4, Gary Schoch3
1Clinical Research Division, Fred Hutchinson Cancer Center, Seattle, WA, USA. ptvo@fredhutch.org.
Bone marrow transplantation
|April 26, 2025
概括
接受全原造血干细胞移植的患者面临17%的随后恶性瘤 (SMNs) 风险. 非黑色素瘤皮肤癌和其他特定的SMN,如子宫腺癌,与慢性移植对宿主疾病有关.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 移植免疫学 移植免疫学
背景情况:
- 全基性造血干细胞移植 (HSCT) 是血液恶性瘤的治愈疗法.
- 非骨髓衰变调节方案旨在减少与治疗相关的毒性,但可能会改变长期风险.
- 随后的恶性瘤 (SMNs) 是HSCT后的一个已知的长期并发症.
研究的目的:
- 为了评估SMN的发生率和类型后非骨髓缩性全源性HSCT.
- 确定与SMN发展相关的风险因素,特别是慢性移植与宿主疾病 (GVHD).
主要方法:
- 对1720名接受异性高血压瘤治疗的患者进行回顾性分析,非骨髓缩条件 (03/1998-08/2023).
- 平均随访时间为12年.
- 观察到的SMN发病率与一般人群预期的发病率的比较 (SEER数据库,如适用).
主要成果:
- 在12年的中位随访后,SMN的总累积发病率为17% (95%CI,15%-19%).
- 非黑色素瘤皮肤癌 (NMSCs) 是最常见的SMN (n=543),与慢性GVHD有显著的关联.
- 与预期率 (73.4) 相比,其他SMN的统计学上显著增加 (n=93) 被观察到 (p=0.03),由子宫腺癌,状唇癌和状阴茎癌驱动,后两个与慢性GVHD相关.
结论:
- 接受非骨髓衰变性异构性HSCT的患者有很大风险患SMN.
- NMSCs和某些其他特定的SMN (子宫腺癌,状唇部/阴茎癌) 增加并与慢性GVHD相关.
- 对SMN的长期监测,特别是在慢性GVHD患者中,在异性HSCT后至关重要.
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