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眼部移植与宿主疾病的危险因素:系统性审查和元分析

Yuanyuan Wang¹, Yuan Min¹, Yanfei Sun¹

¹Department of Hematology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

|June 5, 2025

概括

眼部移植对主体疾病 (oGVHD) 影响37.8%的患者在异构造血型干细胞移植 (allo-HSCT) 后. 老年患者,女性捐赠者和特定的GVHD表现是需要早期干预的关键风险因素.

科学领域:

血液学和免疫学血液学和免疫学
移植医学移植医学
眼科医生眼科眼科

背景情况:

全基性造血干细胞移植 (allo-HSCT) 是血液病的关键治疗方法.
眼部移植对主体疾病 (oGVHD) 是 allo-HSCT 后的常见和衰弱的并发症,影响患者的生活质量.
现有的关于oGVHD风险因素的研究仍然没有确定性,需要进一步调查.

研究的目的:

系统地审查和对现有研究进行元分析,以确定oGVHD的重大风险因素.
建立预防和早期检测oGVHD在alo-HSCT接受者的科学基础.
为临床医生提供基于证据的见解,以识别高风险患者群体.

主要方法:

在多个数据库 (PubMed,Embase,Web of Science等) 进行了全面的文献搜索. 在2024年5月之前.
17项涉及4501名接受allo-HSCT治疗的患者的研究被纳入了系统性审查和元分析.
进行了统计分析,以确定与oGVHD发展相关的因素.

主要成果:

发现oGVHD的总体患病率为37.8%.
确定的重大风险因素包括老年患者年龄,女性捐赠者,匹配相对捐赠者 (MRD),外围造血干细胞 (PBSC) 和并发性急性 (aGVHD) 或慢性 (cGVHD) GVHD.
像口腔GVHD (OR=13.83) 和皮肤GVHD (OR=5.55) 这样的特定表现与oGVHD的发展密切相关.

结论:

这些已识别的因素是oGVHD.的关键早期预警信号.
临床医生可以利用这些发现来识别高风险患者,及时进行干预和治疗策略.
这一元分析为oGVHD后合金HSCT的积极管理提供了坚实的基础.

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