Blood:造血细胞移植治疗慢性肉芽肿性疾病:712例病例研究

2020-07-14 MedSci原创 MedSci原创

慢性肉芽肿性疾病(CGD)是一种原发性免疫缺陷病,可导致危及生命的感染和炎症并发症。allo-HCT后,712例CGD患者的预后良好,移植失败率和死亡率均较低;HCT应作为 CGD年轻患者的治疗选择,

慢性肉芽肿性疾病(CGD)是一种原发性免疫缺陷病,可导致危及生命的感染和炎症并发症。异基因造血干细胞移植(allo-HCT)可以治愈患者,但移植指征仍然存在争议。

Chiesa等开展了一项多中心的回顾性研究,对1993年-2018年在EBMT中心进行了allo-HCT移植的712位CGD患者进行分析。

这712位CGD患者,包括635位儿童(<18岁)和77位成年人。中位随访45个月。移植时的中位年龄为7岁(范围 0.1-48.6岁)。3年OS和EFS的Kaplan-Meier估计值分别为85.7%(95% CI 82.8-88.5)和75.8%(95% CI 72.3-79.3)。在MVA中,年长于存活率降低和慢性GVHD发生率增加有关。虽然成年患者的3年OS和EFS分别为76% (95% CI 66-86)和69% (95% CI 57-80)。

采用一抗原错配供体与OS和EFS降低有关。在一小群接受错配抗原不止一个的供体来源造血细胞移植的患者中,OS无明显差异,但EFS现在降低(HR 3.69,p=0.001)。

调理方案的选择不影响OS或EFS。

总而言之,本研究表明,CGD患者经allo-HCT治疗后的预后极好,无论是在哪个年龄段,移植失败率和死亡率均较低。年长患者和接受一抗原错配移植物的患者的预后相对不那么好。移植应被强烈考虑作为年轻患者,特别是在有完美匹配供体的情况下,的治疗选择。

原始出处:

Robert Chiesa,et al. Haematopoietic Cell Transplantation in Chronic Granulomatous Disease: a Study on 712 Children and Adults. Blood. July 2,2020.

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    2020-07-16 俅侠
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2018 中国白血病异基因造血干细胞移植后复发的监测,治疗和预防共识(英文版)

同种异体造血肝细胞移植(allo-HSCT)是白血病患者一项重要的治疗方法,然而,疾病复发仍是移植后患者死亡的主要原因。本文主要总结了白血病异基因造血干细胞移植后复发的监测,治疗和预防的相关内容并提出相应指导建议。

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