Invasive fungal disease is associated with chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplant: a single center, retrospective study
Invasive fungal disease is associated with chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplant: a single center, retrospective study
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侵袭性真菌病与异基因造血干细胞移植后慢性移植物抗宿主病相关：单中心回顾性研究
DOI：
10.1007/s15010-018-01265-3
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发表时间：
2019-04-01
期刊：
影响因子：
7.5
通讯作者：
Liu, Qifa
中科院分区：
文献类型：
--
作者：
Jin, Hua;Fan, Zhiping;Liu, Qifa
侵袭性真菌病(IFD)和移植物抗宿主病(GVHD)是异基因造血干细胞移植(allo-HSCT)后发病率和死亡率的主要原因。方法我们对510例接受异基因造血干细胞移植的恶性血液病患者进行了回顾性研究，以探讨其对慢性移植物抗宿主病的影响。结果移植物抗宿主病患者移植后总体(局限性和广泛性)和广泛性慢性移植物抗宿主病的2年累积发生率高于非移植物抗宿主病患者(69.5% ± 4.2%vs 32.9% ± 2.4%，P<； .001；43.0% ± 5.2%vs 6.6% ± 1.4%，P<； .001)。与移植相关的病死率高，5年总生存率低，5年无病生存率低(29.8% ± 4.3%vs 9.8% ± 1.6%，P<； .001；50.5% ± 4.9%vs 71.3% ± 2.4%，P<； .001和48.8% ± 4.7%vs 71.8% ± 2.3%，P<； .001)。多变量分析显示IFD增加了慢性GVHD的风险。结论IFD在allo-HSCT后慢性GVHD的发生中起重要作用。
BackgroundInvasive fungal disease (IFD) and graft-versus-host disease (GVHD) are major causes of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, the impacts of IFD on chronic GVHD remain unknown.MethodsWe conducted a retrospective study of 510 patients with hematologic malignancy undergoing allo-HSCT to explore the effects of IFD on chronic GVHD.ResultsThe 2-year cumulative incidences of overall (limited and extensive) and extensive chronic GVHD post-transplantation were higher in patients with IFD compared with those without IFD (69.5% ± 4.2% versus 32.9% ± 2.4%,P< .001; 43.0% ± 5.2% versus 6.6% ± 1.4%,P< .001, respectively). Moreover, the patients with IFD had higher 5-year transplant-related mortality, lower 5-year overall survival and lower 5-year disease-free survival (29.8% ± 4.3% versus 9.8% ± 1.6%,P< .001; 50.5% ± 4.9% versus 71.3% ± 2.4%,P< .001 and 48.8% ± 4.7% versus 71.8% ± 2.3%,P< .001, respectively). Multivariable analyses demonstrated that IFD increased the risk of chronic GVHD.ConclusionOur results suggest that IFD significantly contributes to the development of chronic GVHD after allo-HSCT.