Mitigation of late renal and pulmonary injury after hematopoietic stem cell transplantation.
Mitigation of late renal and pulmonary injury after hematopoietic stem cell transplantation.
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DOI：
10.1016/j.ijrobp.2011.05.081
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发表时间：
2012-05-01
影响因子：
7
通讯作者：
Moulder, John E.
中科院分区：
文献类型：
--
作者：
Cohen, Eric P.;Bedi, Manpreet;Irving, Amy A.;Jacobs, Elizabeth;Tomic, Rade;Klein, John;Lawton, Colleen A.;Moulder, John E.
更新一项临床试验的结果，该试验评估了血管紧张素转换酶抑制剂卡托普利在为造血干细胞移植（HSCT）做准备时接受全身照射（TBI）的受试者中，是否能有效减轻慢性肾功能衰竭和肺相关死亡率。我们对55名随机对照试验参与者的最新记录进行了分析。其中28人服用卡托普利，27人服用安慰剂。tbi - hsct相关慢性肾功能衰竭（和复发）的定义与2007年的分析相同。肺相关死亡率是基于临床或尸检结果肺衰竭或感染作为主要死亡原因。使用国家死亡指数补充了总体死亡率和肺相关死亡率的随访数据。卡托普利组发生tbi - hsct相关慢性肾衰竭的风险（4年时为11%）低于安慰剂组（4年时为17%），但差异无统计学意义（p < 0.05）。使用国家死亡指数大大延长了对死亡率的分析，在67个月之前，没有患者因死亡以外的原因失去随访。与安慰剂组相比，卡托普利组的患者生存率更高，但差异无统计学意义（p < 0.05）。肺死亡率的降低（卡托普利组4年风险为11%，安慰剂组为26%，p=0.15）比慢性肾衰竭的降低更能影响生存率的提高。对复发风险无不良影响（p=0.4）。卡托普利治疗在TBI后未产生可检测到的不良反应。卡托普利治疗可降低放射基础造血干细胞移植后的总体死亡率和肺相关死亡率，并有减缓慢性肾衰竭的趋势。
To update the results of a clinical trial that assessed whether the angiotensin-converting enzyme inhibitor captopril was effective in mitigating chronic renal failure and pulmonary-related mortality in subjects undergoing total body irradiation (TBI) in preparation for hematopoietic stem cell transplantation (HSCT). Updated records of the 55 subjects who were enrolled in this randomized controlled trial were analyzed. There were 28 on captopril and 27 on placebo. The definitions of TBI-HSCT-related chronic renal failure (and relapse) were the same as in the 2007 analysis. Pulmonary-related mortality was based on clinical or autopsy findings of pulmonary failure or infection as the primary cause of death. Follow-up data for overall and pulmonary-related mortality was supplemented by use of the National Death Index. The risk of TBI-HSCT-related chronic renal failure was lower in the captopril group (11% at 4 years) than in the placebo group (17% at 4 years) but this was not statistically significant (p>0.2). Analysis of mortality was greatly extended by use of the National Death Index, and no patients were lost to follow-up for reasons other than death prior to 67 months. Patient survival was higher in the captopril compared with the placebo group, but this was not statistically significant (p>0.2). The improvement in survival was influenced more by a decrease in pulmonary mortality (11% risk at 4 years in the captopril group vs. 26% in the placebo group, p=0.15) than by the decrease in chronic renal failure. There was no adverse effect on relapse risk (p=0.4). Captopril therapy produces no detectable adverse effects when given after TBI. Captopril therapy reduces overall and pulmonary-related mortality after radiation-based HSCT and there is a trend towards mitigation of chronic renal failure.
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DOI：
10.1016/s0360-3016(96)00123-x
发表时间：
1996-08-01
影响因子：
7
作者：
Gore, EM;Lawton, CA;Lipchik, RJ
通讯作者：
Lipchik, RJ
DOI：
10.3109/02841866409134143
发表时间：
1964-01-01
期刊：
ACTA RADIOLOGICA-THERAPY PHYSICS BIOLOGY
影响因子：
--
作者：
LUXTON, RW;KUNKLER, PB
通讯作者：
KUNKLER, PB
DOI：
10.1016/j.ijrobp.2009.07.1743
发表时间：
2009-12-01
影响因子：
7
作者：
Ghosh, Swarajit N.;Zhang, Rong;Fish, Brian L.;Semenenko, Vladmir A.;Li, X. Allen;Moulder, John E.;Jacobs, Elizabeth R.;Medhora, Meetha
通讯作者：
Medhora, Meetha
影响因子：
13.6
作者：
Hingorani, Sangeeta
通讯作者：
Hingorani, Sangeeta
DOI：
10.1016/j.ijrobp.2005.02.032
发表时间：
2005-11-01
影响因子：
7
作者：
Sampath, S;Schultheiss, TE;Wong, J
通讯作者：
Wong, J