Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical hematopoietic stem cell transplantation in acute myeloid leukemia
Risk factors for chronic graft-versus-host disease after anti-thymocyte globulin-based haploidentical hematopoietic stem cell transplantation in acute myeloid leukemia
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急性髓系白血病抗胸腺细胞球蛋白半相合造血干细胞移植后发生慢性移植物抗宿主病的危险因素
DOI：
10.1007/s11684-019-0702-z
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发表时间：
2019-09
期刊：
影响因子：
--
通讯作者：
Mo X.
中科院分区：
文献类型：
--
作者：
Lv M.;Zhang X.;Xu L.;Wang Y.;Yan C.;Chen H.;Chen Y.;Han W.;Wang F.;Wang J.;Liu K.;Huang X.;Mo X.
慢性移植物抗宿主病（cGVHD）是非操作性单倍体相合造血干细胞移植（haplo-HSCT）后的主要并发症。我们的目的是确定接受抗胸腺细胞球蛋白单倍HSCT治疗急性髓系白血病（n= 280）的患者中cGVHD的风险因素。cGVHD的诊断符合美国国立卫生研究院的共识标准。共有169例患者患有cGVHD。有3个位点错配的患者8年cGVHD发生率高于有1 ~ 2个位点错配的患者（总发生率66.0%vs.53.7%，P = 0.031;中重度发生率42.4%vs.30.1%，P = 0.036）。有母体供体的患者8年中重度cGVHD发生率高于有其他供体的患者（49.2%vs.32.9%，P = 0.024）。发生Ⅲ ~ Ⅳ级急性GVHD（aGVHD）患者8年cGVHD发生率明显高于无aGVHD患者（总发生率88.0%vs.50.4%，P < 0.001;中~重度发生率68.0%vs.27.0%，P < 0.001）。在多变量分析中，III至IV级aGVHD是cGVHD的唯一独立危险因素。因此，应考虑对严重aGVHD患者进行进一步干预以预防cGVHD。
Chronic graft-versus-host disease (cGVHD) is a major complication following unmanipulated haploidentical hematopoietic stem cell transplantation (haplo-HSCT). We aimed to identify the risk factors for cGVHD in patients who underwent anti-thymocyte globulin-based haplo-HSCT for acute myeloid leukemia (n= 280). The diagnosis of cGVHD was in accordance with the National Institutes of Health consensus criteria. A total of 169 patients suffered from cGVHD. The patients who had 3 loci mismatched had a higher 8-year incidence of cGVHD (total, 66.0% vs. 53.7%,P= 0.031; moderate to severe, 42.4% vs. 30.1%,P= 0.036) than the patients who had 1 to 2 loci mismatched. The patients who had maternal donors had a higher 8-year incidence of moderate to severe cGVHD (49.2% vs. 32.9%,P= 0.024) compared with the patients who had other donors. The patients who had grades III to IV acute GVHD (aGVHD) had higher 8-year incidence of cGVHD (total, 88.0% vs. 50.4%,P< 0.001; moderate to severe, 68.0% vs. 27.0%,P< 0.001) compared with the patients without aGVHD. In multivariate analysis, grades III to IV aGVHD was the only independent risk factor for cGVHD. Thus, further interventions should be considered in patients with severe aGVHD to prevent cGVHD.
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影响因子：
2
作者：
T. Gooley;Ted Gooley;W. Leisenring;W. Leisenring;J. P. Crowley;J. Crowley;B. Storer;B. Storer
通讯作者：
T. Gooley;Ted Gooley;W. Leisenring;W. Leisenring;J. P. Crowley;J. Crowley;B. Storer;B. Storer
对于首次完全缓解的中危或高危急性髓系白血病患者，半相合相关干细胞移植作为缓解后治疗优于单纯化疗
影响因子：
20.3
作者：
Huang, Xiao-Jun;Zhu, Hong-Hu;Wang, Yu
通讯作者：
Wang, Yu
影响因子：
6.2
作者：
Wang, Yu;Liu, Dai-Hong;Huang, Xiao-Jun
通讯作者：
Huang, Xiao-Jun
影响因子：
4.8
作者：
Sk Sohn;DH Kim;Jh Baek;JG Kim;KB Lee;K. Lee;J. Lee;S. Choi;I. Shin
通讯作者：
Sk Sohn;DH Kim;Jh Baek;JG Kim;KB Lee;K. Lee;J. Lee;S. Choi;I. Shin
影响因子：
158.5
作者：
WEIDEN, PL;SULLIVAN, KM;THOMAS, ED
通讯作者：
THOMAS, ED