Acute renal failure requiring dialysis after allogeneic blood and marrow transplantation identifies very poor prognosis patients
Acute renal failure requiring dialysis after allogeneic blood and marrow transplantation identifies very poor prognosis patients
复制标题
异体血液和骨髓移植后需要透析的急性肾功能衰竭患者预后极差
DOI：
10.1038/sj.bmt.1704144
复制
发表时间：
2003
影响因子：
4.8
通讯作者：
P. McCarthy
中科院分区：
文献类型：
--
作者：
T. Hahn;C. Rondeau;A. Shaukat;V. Jupudy;Austin Miller;A. Alam;M. Baer;B. Bambach;Z. Bernstein;A. Chanan;M. Czuczman;J. L. Slack;M. Wetzler;B. Mookerjee;J. Silva;P. McCarthy
摘要：我们在一个由 97 名连续同种异体血液和骨髓移植 (alloBMT) 患者组成的 3 年队列中检查了需要透析的急性肾衰竭（肾 Bearman 等级 [BG] 3）的发生率、危险因素和相关死亡率。总共有 20 人 (21%) 出现肾 BG3（全部在 +132 天前死亡），77 人 (79%) 出现肾功能不全（肾 BG1-2）。肾 BG3 是 18 名 (90%) 患者死亡时继续需要透析的死亡原因或主要原因。死亡与肾衰竭无关的两名肾BG3患者死于出血+103天和基础疾病+132天。通过单变量分析，年龄、无关供体、静脉闭塞性疾病（VOD）和累及肝脏的 III-IV 级急性移植物抗宿主病与肾 BG3 显着相关。肾 BG3 时间多变量模型仅将先前诊断的严重急性 GVHD（RR=4.1，95% CI 1.6-10.3，P=0.003）和 VOD（RR=9.1，95% CI 3.5-23.7，P<0.001）确定为显着的独立预测因子。肾 BG3 通常被认为是与预处理方案相关的毒性。这项研究表明，肾 BG3 是同种异体血液和骨髓移植后最常见的肝脏合并症并发症，并且识别出预后非常差的患者。
Summary:We examined the incidence, risk factors and associated mortality of acute renal failure requiring dialysis (Renal Bearman Grade [BG] 3) in a 3-year cohort of 97 consecutive allogeneic blood and marrow transplantation (alloBMT) patients. In all, 20 (21%) developed Renal BG3 (all died by day +132) and 77 (79%) developed renal insufficiency (Renal BG1-2). Renal BG3 was a contributing or primary cause of death in 18 (90%) patients who continued to require dialysis at time of death. The two Renal BG3 patients whose deaths were not related to renal failure died on day +103 of hemorrhage and day +132 of underlying disease. By univariate analysis, age, unrelated donor, veno-occlusive disease (VOD) and grade III–IV acute graft-versus-host disease with hepatic involvement were significantly associated with Renal BG3. The multivariate model of time to Renal BG3 determined only a prior diagnosis of severe acute GVHD (RR=4.1, 95% CI 1.6–10.3, P=0.003) and VOD (RR=9.1, 95% CI 3.5–23.7, P<0.001) as significant independent predictors. Renal BG3 is generally considered a conditioning regimen-related toxicity. This study demonstrates that Renal BG3 is most commonly a complication of hepatic co-morbidities after allogeneic blood and marrow transplantation and identifies patients with a very poor prognosis.
登录
查看更多内容
影响因子：
45.3
作者：
BEARMAN, SI;APPELBAUM, FR;THOMAS, ED
通讯作者：
THOMAS, ED
HLA 基因型相同的兄弟姐妹和 HLA 表型相同的无关供体骨髓移植后发病率和死亡率的比较。
影响因子：
4.8
作者：
Bearman,SI;Mori,M;Beatty,PG;Meyer,WG;Buckner,CD;Petersen,FB;Sanders,JE;Anasetti,C;Martin,P;Appelbaum,FR
通讯作者：
Appelbaum,FR
影响因子：
158.5
作者：
CHAO, NJ;SCHMIDT, GM;FORMAN, SJ
通讯作者：
FORMAN, SJ
急性移植物抗宿主病：同种异体骨髓移植后危险因素分析以及环孢素和甲氨蝶呤预防。
影响因子：
20.3
作者：
Nash,RA;Pepe,MS;Storb,R;Longton,G;Pettinger,M;Anasetti,C;Appelbaum,FR;Bowden,RA;Deeg,HJ;Doney,K
通讯作者：
Doney,K