优化对儿科血细胞移植的哈普洛特异性捐赠者选择
Nicole Liberio1, Mariam Allbee-Johnson2, Kwang Woo Ahn2,3
1Department of Pediatrics, Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Medical College of Wisconsin, Milwaukee, WI.
概括
较年轻的单一捐赠者 (<18岁) 降低了儿科血造细胞移植中移植与宿主疾病 (GVHD) 的风险. 兄弟姐妹捐赠者优先于父母捐赠者,特别是母亲,以尽量减少急性和慢性GVHD.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 儿科瘤学 儿科瘤学
背景情况:
- 为儿科血造细胞移植选择平分异性捐赠者需要严格的指导.
- 捐赠者关系 (父母,兄弟姐妹,大家庭) 对移植与宿主疾病 (GVHD) 结果的影响尚未完全理解.
研究的目的:
- 评估捐赠者的年龄和关系对儿科患者急性 (aGVHD) 和慢性 (cGVHD) 移植与宿主疾病的影响.
- 提供关于为儿科半同源干细胞移植选择最佳供体的指导.
主要方法:
- 在2013-2019年间对1,069名儿科接受者 (<19岁) 进行血造细胞移植的分析.
- 主要终点的评估:aGVHD频率在100天和cGVHD累积发病率在2年.
- 多变量分析考虑了供体年龄 (<18,18-35,>35岁) 和供体关系 (父母,兄弟姐妹).
主要成果:
- 较年轻的捐赠者 (<18岁) 与较年长的捐赠者相比,aGVHD和cGVHD的发病率明显较低.
- 父母捐赠者,特别是母亲,与兄弟捐赠者相比,患aGVHD和cGVHD的风险更高.
- 孕产妇捐赠者不论年龄,都会增加GVHD风险,与兄弟捐赠者相比,aGVHD和cGVHD的发病率更高.
结论:
- 18岁以下的捐赠者在儿科单体移植中与降低的aGVHD和cGVHD有关.
- 母亲捐赠者与cGVHD的风险增加有关.
- 对于儿科患者来说,应该优先考虑兄弟姐妹的捐赠者,以尽量减少GVHD风险.
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