Late effects in survivors of acute leukemia treated with hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study
Late effects in survivors of acute leukemia treated with hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study
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DOI：
10.1038/leu.2010.210
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发表时间：
2010-12-01
期刊：
影响因子：
11.4
通讯作者：
Bhatia, S.
中科院分区：
文献类型：
--
作者：
Baker, K. S.;Ness, K. K.;Bhatia, S.
骨髓移植幸存者研究是一项回顾性队列研究，其中在 1974 年至 1998 年间接受造血细胞移植 (HCT) 并存活 2 年以上的参与者完成了一份包含 255 项的问卷，内容涉及 HCT 后发生的后期影响。其中 281 名幸存者患有急性髓系白血病 (AML)，120 名幸存者患有急性淋巴细胞白血病 (ALL)。招募参与者的兄弟姐妹 (n = 319) 进行比较。受访时幸存者的中位年龄为 36.5 岁，兄弟姐妹的中位年龄为 44 岁。 HCT 后的中位随访时间为 8.4 年。调节包括对 86% 的 AML 和 100% 的 ALL 受试者进行全身照射。 ALL 和 AML 幸存者之间的迟发效应频率没有差异。与兄弟姐妹相比，幸存者患糖尿病、甲状腺功能减退、骨质疏松症、运动引起的气短、神经感觉障碍以及平衡、震颤或虚弱问题的频率更高。在多变量分析中，这些结果的风险并没有因诊断而异。同种异体 HCT 后的幸存者患糖尿病（比值比 (OR) = 3.9，P = 0.04）、骨质疏松症（OR = 3.1，P = 0.05）、触觉异常（OR = 2.6，P = 0.02）的几率较高，并报告其总体健康状况为一般或较差（OR = 2.2，P = 0.03）。需要对这些后期影响进行持续监测并采取适当的干预措施，以改善 HCT 后 ALL 和 AML 幸存者的健康状况。白血病（2010）24，2039-2047； doi：10.1038/leu.2010.210； 2010 年 9 月 23 日在线发布
The Bone Marrow Transplant Survivor Study is a retrospective cohort study in which participants who received hematopoietic cell transplantation (HCT) between 1974 and 1998 and survived for >= 2 years completed a 255-item questionnaire on late effects occurring after HCT. There were 281 survivors with acute myeloid leukemia (AML) and 120 with acute lymphoblastic leukemia (ALL). Siblings of participants (n = 319) were recruited for comparison. Median age at interview was 36.5 years for survivors and 44 years for siblings. Median follow-up after HCT was 8.4 years. Conditioning included total body irradiation in 86% of AML and 100% of ALL subjects. The frequencies of late effects did not differ between ALL and AML survivors. Compared with siblings, survivors had a higher frequency of diabetes, hypothyroidism, osteoporosis, exercise-induced shortness of breath, neurosensory impairments and problems with balance, tremor or weakness. In multivariable analysis, the risk of these outcomes did not differ by diagnosis. Survivors after allogeneic HCT had higher odds of diabetes (odds ratio (OR) = 3.9, P = 0.04), osteoporosis (OR = 3.1, P = 0.05), abnormal sense of touch (OR = 2.6, P = 0.02) and reported their overall health as fair or poor (OR = 2.2, P = 0.03). Ongoing surveillance for these late effects and appropriate interventions are required to improve the health status of ALL and AML survivors after HCT. Leukemia (2010) 24, 2039-2047; doi:10.1038/leu.2010.210; published online 23 September 2010