Incidence, Risk Factors and Complications of Ocular Graft-Versus-Host Disease Following Hematopoietic Stem Cell Transplantation
Incidence, Risk Factors and Complications of Ocular Graft-Versus-Host Disease Following Hematopoietic Stem Cell Transplantation
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DOI：
10.1016/j.ajo.2021.02.022
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发表时间：
2021-04-15
影响因子：
4.2
通讯作者：
Bonifazi, Francesca
中科院分区：
文献类型：
--
作者：
Pellegrini, Marco;Bernabei, Federico;Bonifazi, Francesca
中心点 目的：本研究的目的是在一项大型单中心研究中评估眼移植物抗宿主病 (GVHD) 的发病率、危险因素和并发症。中心点设计：回顾性观察病例系列。中心点方法：本研究纳入了 2005 年至 2020 年间接受造血干细胞移植 (HSCT) 的 283 名患者。眼部 GVHD 是根据国际慢性眼病诊断标准诊断的GVHD 共识小组标准。使用Cox比例风险模型评估眼部GVHD的潜在危险因素。中心点结果：眼部GVHD的累积发生率在1年时为19.7％，在2年时为29.3％，在3年时为40.7％，在4年时为47.2％，在5年时为49.7％。眼部 GVHD 与受者年龄显着相关（风险比 [HR]：1.228；95% 置信区间 [CI]：1.033-1.459；P = .020）；女性（HR：1.797；95% CI：1.195-2.703；P = .005）；外周血干细胞的使用（PBSC）（HR：2.079；95% CI：1.268-3.411；P = .004）；和既往急性 GVHD（HR：1.276；95% CI：1.073-1.518；P = .006）。 HSCT 后的眼部并发症包括白内障、角膜溃疡、角膜穿孔、泪道阻塞、疱疹性角膜炎和巨细胞病毒性视网膜炎。中心点结论：半数患者在 HSCT 后 5 年内出现眼部 GVHD。年龄较大、女性、使用 PBSC 和急性 GVHD 疾病是眼部 GVHD 的重要预测因素。血液科医生和眼科医生应该意识到其威胁视力的并发症。 （美国眼科杂志 2021；227：25-34。(c) 2021 Elsevier Inc. 保留所有权利。）
center dot PURPOSE: The purpose of this research was to evaluate the incidence, risk factors, and complications of ocular graft-versus-host disease (GVHD) in a large single-center study.center dot DESIGN: Retrospective observational case series.center dot METHODS: This study included 283 patients who underwent hematopoietic stem cell transplantation (HSCT) between 2005 and 2020. Ocular GVHD was diagnosed according to International Chronic Ocular GVHD Consensus Group criteria. Potential risk factors for ocular GVHD were evaluated using the Cox proportional hazards model.center dot RESULTS: The cumulative incidence of ocular GVHD was 19.7% at 1 year, 29.3% at 2 years, 40.7% at 3 years, 47.2% at 4 years, and 49.7% at 5 years. Ocular GVHD was significantly associated with recipient age (hazard ratio [HR]: 1.228; 95% confidence interval [CI]: 1.033-1.459; P = .020); female sex (HR: 1.797; 95% CI: 1.195-2.703; P = .005); peripheral blood stem cell use (PBSC) (HR: 2.079; 95% CI: 1.268-3.411; P = .004); and previous acute GVHD (HR: 1.276; 95% CI: 1.073-1.518; P = .006). Ocular complications after HSCT included cataract, corneal ulcer, corneal perforation, lacrimal obstruction, herpetic keratitis, and cytomegalovirus retinitis.center dot CONCLUSIONS: Half of patients developed ocular GVHD in the 5 years following HSCT. Older age, female sex, use of PBSC, and acute GVHD disease were significant predictors of ocular GVHD. Hematologists and ophthalmologists should be aware of its vision threating complications. (Am J Ophthalmol 2021;227: 25-34.(c) 2021 Elsevier Inc. All rights reserved.)