Blood:单抗原不匹配非亲缘干细胞移植后,环磷酰胺预防GVHD的效果优于标准方法

2019-07-04 MedSci MedSci原创

抗胸腺细胞球蛋白(ATG)是接受不匹配非亲缘供体(MMUD)移植的患者预防移植物抗宿主(GVHD)的标准方法。近期,有报道提示移植后采用环磷酰胺(PTCY)预防具有一定安全性和可行性,但尚无研究对比PTCY和ATG用于9/10 MMUD移植预防GVHD的预后。

中心点:

与ATG相比,PTCY对于急性髓系白血病患者单抗原不匹配非亲缘供体移植后预防GVHD的效果更好。

采用外周血干细胞作为干细胞来源时,PTCY的效果仍优于ATG。

摘要:

抗胸腺细胞球蛋白(ATG)是接受不匹配非亲缘供体(MMUD)移植的患者预防移植物抗宿主(GVHD)的标准方法。近期,有报道提示移植后采用环磷酰胺(PTCY)预防具有一定安全性和可行性,但尚无研究对比PTCY和ATG用于9/10 MMUD移植预防GVHD的预后。

利用ALWP和EBMT所登记的数据,研究人员开展一配对分析,对比这两种方案用于9/10 MMUD的预后。经筛查,共获得93位接受PTCY处理的患者,179位接受ATG处理的患者。

接受PTCY处理的患者重度急性GVHD的发生率明显低于ATG处理的患者。而且PTCY处理的患者还表现出较高的无白血病率和无GVHD/复发的存活率(GRFS)。当亚组分析涵盖接受外周血干细胞治疗、完全缓解(CR)或接受相同的免疫抑制剂处理时,均证实PTCY优于ATG。

与单倍体设置相似,PTCY是9/10 MMUD移植中的一种有效的抗GVHD预防措施。采用PTCY或可改善长期疾病控制的预后。这一结果需要通过大型前瞻性随机试验来证实。

原始出处:

Giorgia Battipaglia, et al. Post-Transplant Cyclophosphamide versus Antithymocyte Globulin in HLA-Mismatched unrelated Donors transplantation. Blood 2019 :blood.2019000487; doi: https://doi.org/10.1182/blood.2019000487

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1658903, encodeId=a8131658903a8, content=<a href='/topic/show?id=c40ce798412' target=_blank style='color:#2F92EE;'>#细胞移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77984, encryptionId=c40ce798412, topicName=细胞移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4724938298, createdName=limedical1982, createdTime=Thu Aug 01 10:20:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1025296, encodeId=9603102529674, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=独孤立克, createdTime=Sun Jul 07 19:20:00 CST 2019, time=2019-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284368, encodeId=e39b128436883, content=<a href='/topic/show?id=73216852458' target=_blank style='color:#2F92EE;'>#环磷酰胺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68524, encryptionId=73216852458, topicName=环磷酰胺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=07f7192, createdName=waiwai3030, createdTime=Sat Jul 06 10:20:00 CST 2019, time=2019-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1623335, encodeId=d8cd1623335d1, content=<a href='/topic/show?id=62a655263e9' target=_blank style='color:#2F92EE;'>#抗原#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55263, encryptionId=62a655263e9, topicName=抗原)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f59b20519025, createdName=xiaoyeshuang, createdTime=Sat Jul 06 10:20:00 CST 2019, time=2019-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046862, encodeId=bb6710468629e, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Jul 04 22:20:00 CST 2019, time=2019-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369021, encodeId=82c23690216a, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/01/04/2540fb84decb81d47a7f2868070e6cbd.jpg, createdBy=ed3f2205793, createdName=百草, createdTime=Thu Jul 04 20:21:16 CST 2019, time=2019-07-04, status=1, ipAttribution=)]
    2019-07-07 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

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    2019-07-04 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1658903, encodeId=a8131658903a8, content=<a href='/topic/show?id=c40ce798412' target=_blank style='color:#2F92EE;'>#细胞移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77984, encryptionId=c40ce798412, topicName=细胞移植)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ad4724938298, createdName=limedical1982, createdTime=Thu Aug 01 10:20:00 CST 2019, time=2019-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1025296, encodeId=9603102529674, content=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, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=独孤立克, createdTime=Sun Jul 07 19:20:00 CST 2019, time=2019-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1284368, encodeId=e39b128436883, content=<a href='/topic/show?id=73216852458' target=_blank style='color:#2F92EE;'>#环磷酰胺#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68524, encryptionId=73216852458, topicName=环磷酰胺)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=07f7192, createdName=waiwai3030, createdTime=Sat Jul 06 10:20:00 CST 2019, time=2019-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1623335, encodeId=d8cd1623335d1, content=<a href='/topic/show?id=62a655263e9' target=_blank style='color:#2F92EE;'>#抗原#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=55263, encryptionId=62a655263e9, topicName=抗原)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f59b20519025, createdName=xiaoyeshuang, createdTime=Sat Jul 06 10:20:00 CST 2019, time=2019-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046862, encodeId=bb6710468629e, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Thu Jul 04 22:20:00 CST 2019, time=2019-07-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=369021, encodeId=82c23690216a, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/01/04/2540fb84decb81d47a7f2868070e6cbd.jpg, createdBy=ed3f2205793, createdName=百草, createdTime=Thu Jul 04 20:21:16 CST 2019, time=2019-07-04, status=1, ipAttribution=)]
    2019-07-04 百草

    666

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