Onset of ocular graft-versus-host disease symptoms after allogeneic hematopoietic stem cell transplantation.
Onset of ocular graft-versus-host disease symptoms after allogeneic hematopoietic stem cell transplantation.
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DOI：
10.1097/ico.0000000000000340
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发表时间：
2015-03
期刊：
影响因子：
2.8
通讯作者：
Dana R
中科院分区：
文献类型：
--
作者：
Shikari H;Amparo F;Saboo U;Dana R
目的探讨异基因造血干细胞移植（allo-HSCT）患者眼部GVHD发生时间的影响因素。对200例眼部GVHD患者进行了回顾性病历分析，以评估各种供受者特征与allo-HSCT后眼部GVHD发作时间之间的相关性。allo-HSCT后至慢性眼部GVHD发作的中位时间为293天（范围为26至2308天）。与不匹配移植（219天; P=0.029）相比，接受完全HLA匹配移植的患者发生眼部GVHD的时间延迟（中位数294天）。与来自无关供体的HLA匹配（286天; P=0.168）和HLA不匹配（231天; P=0.015）移植物相比，来自相关供体的HLA匹配移植物的眼部GVHD发作延迟（307天）。76%的患者眼部GVHD发生在全身性GVHD之后，但7%的患者发生在全身性疾病之前，15%的患者同时发生，2%的患者与全身性GVHD无关。匹配相关移植组发生全身和眼部GVHD的时间（250天）显著长于匹配无关移植组（120天; P=0.004）。异基因造血干细胞移植后眼部GVHD的发生是可变的，并受供受者匹配特征的影响。在大多数GVHD患者中，眼部受累发生在全身性表现之后;然而，重要的是，少数患者也可以先于或独立于全身性疾病发展。无论并发全身GVHD状态如何，建议allo-HSCT后定期进行眼科随访。
To study the factors affecting the time to onset of ocular GVHD in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). A retrospective chart review of 200 patients with ocular GVHD was performed to evaluate the association between various donor-recipient characteristics on the time to onset of ocular GVHD after allo-HSCT. The median time to onset of chronic ocular GVHD after allo-HSCT was 293 days (range 26 to 2308). Patients receiving fully HLA-matched transplants had a delayed onset of ocular GVHD (median 294 days) compared to mismatched transplants (219 days; P=0.029). HLA-matched transplants from related donors had delayed onset of ocular GVHD (307 days) compared to HLA-matched (286 days; P=0.168) and HLA-mismatched (231 days; P=0.015) transplants from unrelated donors. Ocular GVHD followed systemic GVHD in 76% of patients but preceded systemic disease in 7%, occurred concurrently in 15%, and was not associated with systemic GVHD in 2% of patients. The time elapsed between the occurrence of systemic and ocular GVHD was significantly longer in matched-related transplants (250 days) than in matched-unrelated transplants (120 days; P=0.004). The onset of ocular GVHD after allogeneic hematopoietic stem cell transplantation is variable and is influenced by the donor-recipient matching characteristics. In the majority of patients with GVHD ocular involvement follows the occurrence of systemic manifestations; however, importantly, it can also precede or develop independently of systemic disease in a minority. Regular ophthalmic follow-up is recommended after allo-HSCT regardless the concurrent systemic GVHD status.