Danaparoid reduces transplant-related mortality in stem cell transplantation for children
Danaparoid reduces transplant-related mortality in stem cell transplantation for children
复制标题
达那肝素可降低儿童干细胞移植中移植相关的死亡率
DOI：
10.1111/petr.13099
复制
发表时间：
2017
影响因子：
1.3
通讯作者：
Matsumoto Kimikazu
中科院分区：
文献类型：
--
作者：
Kato Koji;Sakaguchi Hirotoshi;Muramatsu Hideki;Sekiya Yuko;Kawashima Nozomu;Narita Atsushi;Doisaki Sayoko;Watanabe Nobuhiro;Yoshida Nao;Matsumoto Kimikazu
在SCT中，移植相关并发症导致的死亡是阻碍移植结局改善的主要障碍，适当的支持性护理对于减少TRM至关重要。分析了2000年至2013年在我们机构连续接受SCT的210例恶性和非恶性疾病儿科患者的移植结局。移植年份分为三个时期：（2000 - 2004年），B（2005 - 2008），C（2009 - 2013），在这些时间段内观察到5年OS改善和5年TRM降低;也就是说，在A、B和C期，OS分别为61.5%、60.3%和79.5%（P= 0.062），TRM分别为19.9%、7.9%和0.0%（P<0.001）。在多变量分析中，所有患者TRM的预后因素是达那肝素的给药（HR = 0.109，95% CI = 0.033 - 0.363，P <0.001），对于异基因SCT中的恶性血液病患者，预后因素为达那肝素（HR = 0.046，95% CI = 0.006 - 0.326，P =.002）和SCT时的晚期疾病（HR = 4.802，95% CI = 1.734 - 13.30，P =.003）。在SCT后的TRM减少，随着时间的推移，达那肝素的支持性护理被发现在减少儿童SCT中的TRM方面显着有效。
In SCT, death from transplant‐related complications is the major obstacle hindering improvement of transplant outcomes, and proper supportive care is essential to reduce TRM. The transplant outcomes of 210 pediatric patients with malignant and non‐malignant disorders who consecutively underwent SCT in our institution from 2000 to 2013 were analyzed. The transplant years were divided into three periods: A (2000‐2004), B (2005‐2008), and C (2009‐2013), and an improvement in 5‐year OS and a decrease in 5‐year TRM were observed over these time periods; that is, OS was 61.5%, 60.3%, and 79.5% (P=.062), and TRM was 19.9%, 7.9%, and 0.0% (P<.001) in periods A, B, and C, respectively. On multivariate analysis, the prognostic factor for TRM for all patients was administration of danaparoid (HR = 0.109, 95% CI = 0.033‐0.363,P<.001), and for patients with hematological malignancies in allogeneic SCT, the prognostic factors were danaparoid (HR = 0.046, 95% CI = 0.006‐0.326,P=.002) and advanced disease at SCT (HR = 4.802, 95% CI = 1.734‐13.30,P=.003). A reduction in TRM after SCT was observed over the time periods, and supportive care with danaparoid was found to be significantly effective in reducing TRM in SCT for children.