Venous thromboembolism is associated with graft-versus-host disease and increased non-relapse mortality after allogeneic hematopoietic stem cell transplantation.
Venous thromboembolism is associated with graft-versus-host disease and increased non-relapse mortality after allogeneic hematopoietic stem cell transplantation.
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同种异体造血干细胞移植后，静脉血栓栓塞与移植物抗宿主疾病和非释放死亡率有关。
DOI：
10.3324/haematol.2017.164012
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发表时间：
2017-07
期刊：
影响因子：
10.1
通讯作者：
Koreth J
中科院分区：
文献类型：
--
作者：
Kekre N;Kim HT;Ho VT;Cutler C;Armand P;Nikiforow S;Alyea EP;Soiffer RJ;Antin JH;Connors JM;Koreth J
虽然静脉血栓栓塞率和危险因素在癌症患者中有很好的描述，但关于异基因干细胞移植（恶性血液病患者的治愈性治疗）后血栓形成的发生率、危险因素和结局的数据有限。我们的目的是确定异基因干细胞移植中静脉血栓形成的发生率和风险。我们研究了2002-2013年期间在我们机构进行的2276例首次移植受者，中位随访时间为50个月（范围4-146）。通过药房记录和随后的病历审查，确定了190例因静脉血栓而接受全身抗凝治疗的患者。所有静脉血栓形成事件的1年和2年累积发生率分别为5.5%（95%置信区间（CI）4.6-6.5%）和7.1%（95% CI 6.1-8.2%）。在有和无血栓形成的移植受者之间，年龄、性别、体重指数、诊断、疾病风险指数、预处理强度、供体类型或移植物来源没有差异。在多变量模型中，急性和慢性移植物抗宿主病均与血栓形成发生独立相关（风险比（HR）=2.05，95% CI 1.52-2.76; HR=1.71，95% CI 1.19-2.46）。上肢血栓形成在时间、风险因素和临床影响方面与所有其他血栓形成不同，并且与非复发死亡率无关（HR=1.15; 95% CI 0.69-1.90），不像所有其他血栓形成会增加非复发死亡率（HR=1.71; 95% CI 1.17-2.49）。在亚组分析中，通过比较有和无血栓形成的患者来评估传统的血栓形成预测因子，既往静脉血栓形成史是唯一有意义的预测因子。静脉血栓栓塞在异基因干细胞移植后有很高的发病率，并与移植物抗宿主病和非复发死亡率有关。
Although venous thromboembolism rates and risk factors are well described in patients with cancer, there are limited data on the incidence, risk factors and outcomes of thrombosis after allogeneic stem cell transplantation, a curative therapy for patients with hematologic malignancies. We aimed to determine the incidence and risks associated with venous thrombosis in allogeneic stem cell transplants. We studied 2276 recipients of first transplant between 2002–2013 at our institution with a median follow up of 50 months (range 4–146). Using pharmacy records and subsequent chart reviews, 190 patients who received systemic anticoagulation for venous thrombosis were identified. The 1-and 2-year cumulative incidence of all venous thrombotic events were 5.5% (95% confidence interval (CI) 4.6–6.5%) and 7.1% (95% CI 6.1–8.2%), respectively. There was no difference in age, sex, body mass index, diagnosis, disease risk index, conditioning intensity, donor type or graft source between transplant recipients with and without subsequent thrombosis. In multivariable models, both acute and chronic graft-versus-host disease were independently associated with thrombosis occurrence (Hazard ratio (HR)=2.05, 95% CI 1.52–2.76; HR=1.71, 95% CI 1.19–2.46, respectively). Upper extremity thrombosis differed from all other thromboses in terms of timing, risk factors and clinical impact, and was not associated with non-relapse mortality (HR=1.15; 95% CI 0.69–1.90), unlike all other thromboses which did increase non-relapse mortality (HR=1.71; 95% CI 1.17–2.49). In subgroup analysis evaluating conventional thrombosis predictors by comparing patients with and without thrombosis, a history of prior venous thrombosis was the only significant predictor. Venous thromboembolism has a high incidence after allogeneic stem cell transplant and is associated with graft-versus-host disease and non-relapse mortality.
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DOI：
10.4274/tjh.2013.0066
发表时间：
2015-09
期刊：
Turkish journal of haematology : official journal of Turkish Society of Haematology
影响因子：
--
作者：
Azık F;Gökçebay DG;Tavil B;Işık P;Tunç B;Uçkan D
通讯作者：
Uçkan D
影响因子：
20.3
作者：
Armand, Philippe;Kim, Haesook T.;Saber, Wael
通讯作者：
Saber, Wael
影响因子：
20.3
作者：
Gerber, David E.;Segal, Jodi B.;Streiff, Michael B.
通讯作者：
Streiff, Michael B.
影响因子：
10.4
作者：
Gonsalves, A.;Carrier, M.;Allan, D. S.
通讯作者：
Allan, D. S.
影响因子：
10.1
作者：
Labrador, Jorge;Lopez-Anglada, Lucia;Ramon Gonzalez-Porras, Jose
通讯作者：
Ramon Gonzalez-Porras, Jose