Ann Rheum Dis:系统性硬化症自体造血干细胞移植后死亡和主要不良事件的预测因素

2020-05-15 xiangting MedSci原创

HSCT在改善SSc生存率、皮肤和肺部受累方面具有长期疗效。

自体造血干细胞移植(HSCT)可以改善预后较差系统性硬化症(SSc)患者的生存率,但会受到治疗相关性死亡(TRM)的影响。

这项研究旨在评估无事件生存率(EFS)、TRM、治疗反应、疾病进展以及与事件相关的患者特征。

纳入荷兰2017年以前接受HSCT 治疗的所有SSc患者(n=92)。在基线和第1、2、5年时收集皮肤受累(改良Rodnan皮肤评分(mRSS))、肺功能(用力肺活量(FVC)和一氧化碳弥散能力(DLCO))、使用Goh评分的高分辨率CT上间质性肺病的程度和左心室射血分数(LVEF)的数据,收集2019年以前发生的事件,事件定义为死亡或主要器官衰竭。作为对照,比较了环磷酰胺(CYC)治疗的患者与参加了国际硬皮病自体干细胞移植(ASTIS)试验的HSCT患者。

中位随访时间4.6年。估算的5年、10年和15年EFS分别为78%、76%和66%。20例患者死亡。FVC、DLCO、mRSS和Goh评分平均值显著改善。22例患者出现疾病进展。TRM的发生率随时间而下降,并且在男性中更常见。事件与男性、LVEF<50%和年龄大独立相关。在ASTIS中,接受HSCT治疗的患者(n=23)出现了7个事件,而CYC组为13个(n=22)。

这项研究数据证实了HSCT在改善SSc生存率、皮肤和肺部受累方面具有长期疗效。男性、基线时LVEF低和年龄大被确定为事件的危险因素。

原始出处:

Sandra van Bijnen. Predictive factors for treatment-related mortality and major adverse events after autologous haematopoietic stem cell transplantation for systemic sclerosis: results of a long-term follow-up multicentre study. Ann Rheum Dis. 14 May 2020.

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    2020-05-18 独孤立克

    干细胞是热点,但是进入临床仍然需要时间和临床疗效验证哦

    0

  6. 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  8. 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    2020-05-17 俅侠
  9. 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  10. 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