异构血型干细胞移植后的短期心脏毒性:回顾性单一中心体验
Jean El Cheikh1, Ibrahim Hasan2, Mustafa Saleh3
1Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut, Medical Center, Beirut, Lebanon.
Clinical hematology international
|July 7, 2025
概括
异质造血干细胞移植 (allo-HSCT) 可以导致短期的心脏问题,包括排泄率下降和腹功能障碍. 特定的调节方案和药物增加心脏毒性风险,需要心脏移植后监测.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 全源性造血干细胞移植 (allo-HSCT) 是一种治疗血液病的疗法.
- 阿洛-HSCT与显著的短期和长期心血管不良影响有关.
- 了解早期心脏毒性对于患者管理和长期结果至关重要.
研究的目的:
- 评估allo-HSCT后的短期心血管后果.
- 为了比较与不同调节方案和预防药物相关的心脏毒性风险.
- 为了评估移植后的左心室喷射分数 (LVEF) 和舒张功能的变化.
主要方法:
- 在AUBMC接受allo-HSCT的310名患者的回顾性研究.
- 在移植前和移植后100天内对心脏功能的心声图评估.
- 对心脏毒性风险的调节方案 (例如,顺序) 和药物 (例如,环胺) 的分析.
主要成果:
- 观察到LVEF从59.14%到58.44% (P=0.037) 的平均值显著下降.
- 在E波,E'波和E/A比率的显著下降表明透缩功能障碍.
- 顺序移植,循环胺和顺序调节方案与减少LVEF (P=0.002,0.007,0.019) 有关.
结论:
- 短期心脏变化,包括亚临床的LVEF和腹功能障碍,发生在HSCT后.
- 特定的移植类型 (haploidentical) 和治疗方法 (cyclophosphamide,顺序调节) 会增加心脏毒性风险.
- 建议进行串行心声回声监测,以评估临床相关性和长期心脏毒性风险.
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