[Clinical features and risk factors analysis of acute graft-versus-host disease in patients with related HLA-haploidentical non T cell-depleted in vitro peripheral hematopoietic stem cell transplantation].
[Clinical features and risk factors analysis of acute graft-versus-host disease in patients with related HLA-haploidentical non T cell-depleted in vitro peripheral hematopoietic stem cell transplantation].
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DOI：
10.3760/cma.j.issn.0253-2727.2014.12.012
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发表时间：
2014-12-01
影响因子：
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通讯作者：
Cao, Haizhou
中科院分区：
文献类型：
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作者：
Xue, Wenjing;Jiang, Ming;Cao, Haizhou
目的：探讨急性移植物抗宿主病（aGVHD）的临床特征及其相关HLA半相合非T细胞耗竭体外外周造血干细胞移植（RHNT-PBSCT）的危险因素。方法：收集2002年7月至2012年12月接受RHNT-PBSCT的104例患者，分析其发生情况、部位及其危险因素。 aGVHD，与同期接受HLA相合同胞非T细胞耗竭体外PBSCT（MSNT-PBSCT）的103例患者相比。结果：（1）RHNT-PBSCT组aGVHD累积发生率显着高于MSNT-PBSCT组[（56.2±4.7）% vs（34±3.6）%，P0.05； (12.6±4.1)% vs (10.8±2.4)%, P>0.05]。 (2)RHNT-PBSCT组皮肤aGVHD累积发生率显着高于MSNT-PBSCT组[(42.3±3.2)% vs (17.5±2.3)%, P0.05； (16.3±4.5)% vs (10.3±2.5)%, P>0.05]。 (3)RHNT-PBSCT组和MSNT-PBSCT组的3年无病生存率(DFS)和总生存率(OS)分别为(63±5.5)%、(65.2±4.7)%和(74.2±5.4)%、(77.4±5)%,差异无统计学意义(P=0.078,P=0.052)。 (4)单因素分析表明aGVHD的发生与HLA单倍型(P=0.003)和匹配位点(P=0.002)显着相关。多因素分析显示，仅HLA分型是aGVHD的危险因素（HR=1.891，P=0.03）。结论：虽然RHNT-PBSCT方案中总aGVHD的发生率高于MSNT-PBSCT，但重度aGVHD无显着性，且以皮肤aGVHD为常见类型，提示RHNT-PBSCT方案是可行的。
OBJECTIVE: To study the clinical features of acute graft-versus-host disease (aGVHD) and its risk factors for the related HLA-haploidentical non T cell-depleted in vitro peripheral hematopoietic stem cell transplantation (RHNT-PBSCT).METHODS: From July 2002 to December 2012, 104 patients who underwent the RHNT-PBSCT were enrolled to analyze the incidences, location and its risk factors of aGVHD, compared with those of the 103 patients who received the HLA-matched sibling non T cell-depleted in vitro PBSCT (MSNT-PBSCT) in the same period.RESULTS: (1)The cumulative incidence of aGVHD in the RHNT-PBSCT group was significantly higher than the MSNT-PBSCT group [(56.2±4.7)% vs (34±3.6)%, P0.05; (12.6±4.1)% vs (10.8±2.4)%, P>0.05]. (2)The cumulative incidence of cutaneous aGVHD was significantly higher in RHNT-PBSCT group than that in MSNT-PBSCT group [(42.3±3.2)% vs (17.5±2.3)%, P0.05; (16.3±4.5)% vs (10.3±2.5)%, P>0.05]. (3)The 3-year disease free survival (DFS) and overall survival(OS) of RHNT-PBSCT group and MSNT-PBSCT group were (63±5.5)%, (65.2±4.7)% and (74.2±5.4)%, (77.4±5)% respectively, without significance (P=0.078, P=0.052). (4)aGVHD occurrence with HLA haplotype (P=0.003) and matched loci (P=0.002) were significantly correlated by univariate analysis. Multivariate analysis showed that only the HLA typing is a risk factor for aGVHD (HR=1.891, P=0.03).CONCLUSION: Although the incidence of total aGVHD in RHNT-PBSCT protocol is higher than that in MSNT-PBSCT, but there was no significance in severe aGVHD and cutaneous aGVHD was the common type, which indicates that RHNT-PBSCT protocol is feasible.