Allogeneic peripheral blood stem cell transplantation may be associated with a high risk of chronic graft-versus-host disease
Allogeneic peripheral blood stem cell transplantation may be associated with a high risk of chronic graft-versus-host disease
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DOI：
10.1182/blood.v90.12.4705.4705_4705_4709
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发表时间：
1997-12-15
期刊：
影响因子：
20.3
通讯作者：
Appelbaum, FR
中科院分区：
文献类型：
--
作者：
Storek, J;Gooley, T;Appelbaum, FR
慢性移植物抗宿主病（GVHD）可能由供体T淋巴细胞引起。由于未修饰的造血干细胞移植物比未修饰的骨髓移植物含有多一个对数的T淋巴细胞，我们评估了先前报道的37名造血干细胞接受者和37名计算机匹配的历史对照骨髓接受者中慢性GVHD的发生率（Bensinger等，Blood 88：2794，1996）。所有患者均随访至死亡、复发或发生慢性GVHD或至少2年。在一个单变量比例风险回归模型中，外周血干细胞受体与骨髓受体相比，移植后2年发生临床慢性GVHD（包括临床局限性和临床广泛性疾病）的相对风险为2.22（95%置信区间，1.04至4.74; P = 0.039）。对于临床广泛的慢性GVHD，相对风险为2.37（95%置信区间，1.07至5.29; P = 0.035）。在多变量分析中，同时考虑患者年龄、患者巨细胞病毒血清状态和供体巨细胞病毒血清状态的协变量，临床慢性GVHD和临床广泛慢性GVHD的相对风险也大于2（P
Chronic graft-versus-host disease (GVHD) is likely caused by donor T lymphocytes. Because unmodified blood stem cell grafts contain one log more T lymphocytes than unmodified marrow grafts, we evaluated the incidence of chronic GVHD in previously reported 37 blood stem cell recipients and 37 computer-matched historical control marrow recipients (Bensinger et al, Blood 88:2794, 1996). AII patients have been followed until death, relapse, or occurrence of chronic GVHD or for a minimum of 2 years. In a univariable proportional hazards regression model, the relative risk of developing clinical chronic GVHD (includes clinical limited and clinical extensive disease) by 2 years posttransplant among the peripheral blood stem cell recipients compared with the marrow recipients was 2.22 (95% confidence interval, 1.04 to 4.74; P =.039). For clinical extensive chronic GVHD, the relative risk was 2.37 (95% confidence interval, 1.07 to 5.29; P =.035). In multivariable analyses, considering also the covariables of patient age, patient cytomegalovirus serostatus, and donor cytomegalovirus serostatus, the relative risks of clinical chronic GVHD and clinical extensive chronic GVHD were also greater than 2 (P