Blood:美国70岁及以上的恶性血液病患者接受异体造血干细胞移植的情况

2017-07-04 qinqiyun MedSci原创

在过去的十年,在70岁及以上的患者中进行异体造血干细胞移植的利用率和存活期都有所增加。

目的:统计在的恶性血液病患者接受异体造血干细胞移植(HCT)的趋势和结果。

方法:统计2000年-2013年间70岁及以上恶性血液病患者第一次接受异体HCT的病例数。研究的移植的利用率和结果包括总存活数(OS)、无进展生存期(PFS)和移植相关性死亡(TRM)。

结果:2000年-2013年103家移植中心的1106位70岁及以上的患者接受了HCT。在近10年里同种异体移植的数量和比例都有明显增加,从2000年的0.1%到2013年的3.85%(N=298)。急性髓性白血病和骨髓增生异常综合征是主要的适应征。两年内的OS和PFS都显着增加(OS,2000-2007年的26% [95% CI, 21%-33%]到2008-2013年的39% [95% CI, 35%-42%],P< 0.001;PFS, 由22% [16%-28%]到32% [95% CI, 29%-36%],P= 0.003)。两年内移植相关的死亡约33-35%,未见明显改变。2008-2013年中期对OS的多变量分析提示造血细胞移植死亡率更高——死亡指数 ≥3(HR= 1.27, P= 0.006),脐带血移植 (HR=1.97, P= 0.0002),并且会有骨髓移植的副反应。

结论:在过去的十年,在70岁及以上的患者中进行异体造血干细胞移植的利用率和存活期都有所增加。部分70岁及以上的恶性血液病患者应该考虑移植。

原始出处:

Lori Muffly,Marcelo C.Pasquini,et al.Increasing use of allogeneic hematopoietic cell transplantation in patients age 70 years and older in the United States.Blood  2017.https://doi.org/10.1182/blood-2017-03-772368 .


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    2017-07-06 俅侠
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