The importance of age, fludarabine, and total body irradiation in the incidence and severity of chronic renal failure after allogeneic hematopoietic cell transplantation
The importance of age, fludarabine, and total body irradiation in the incidence and severity of chronic renal failure after allogeneic hematopoietic cell transplantation
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DOI：
10.1016/j.bbmt.2005.08.036
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发表时间：
2006-01-01
影响因子：
4.3
通讯作者：
Mackinnon, S
中科院分区：
文献类型：
--
作者：
Delgado, J;Cooper, N;Mackinnon, S
包括慢性肾功能衰竭（CRF）在内的非恶性晚期效应损害了异基因造血细胞移植后长期存活者的生活质量。其中一个主要的风险因素是全身照射（TBI）的准备方案中的使用; TBI目前是分次，试图减少毒性。我们分析了241名接受基于TBI的异基因造血细胞移植准备方案的患者。TBI剂量分别为7.5戈伊（7.5S组）、12戈伊（6次）（12 F组）或14.4戈伊（8次）（14.4 F组）。2年时CRF的累积发生率为12%。统计分析显示，年龄较大（P <0.001）和氟达拉滨给药（P = 0.016）对CRF的发生率有显著影响。此外，单次TBI也与CPF严重程度显著相关，因为7.5S组111例患者中有7例（6.3%）发生重度CRF，而12 F和14.4F组130例患者中有1例（0.8%）发生重度CRF（P = 0.044）。然而，鉴于本研究的回顾性和非随机化性质，这些结论应被视为初步结论。(c)2006年美国血液和骨髓移植学会。
Nonmalignant late effects, including chronic renal failure (CRF), impair the quality of life of long-term survivors after allogeneic hematopoietic cell transplantation. One of the major risk factors is the use of total body irradiation (TBI) in the preparative regimen; TBI is currently fractionated in an attempt to reduce toxicity. We analyzed 241 patients who had TBI-based preparative regimens for allogeneic hematopoietic cell transplantation. TBI was delivered as a single fraction of 7.5 Gy (7.5S group), 12 Gy in 6 fractions (12F group), or 14.4 Gy in 8 fractions (14.4F group). The cumulative incidence of CRF at 2 years was 12%. Statistical analysis revealed that older age (P < .001) and fludarabine administration (P =.016) had a significant effect on the incidence of CRF. Furthermore, single-fraction TBI was also significantly associated with CPF severity, because 7 (6.3%) of 111 patients in the 7.5S group developed severe CRF, as opposed to 1 (0.8%) of 130 patients in the 12F and 14.4F groups combined (P =.044). However, these conclusions should be regarded as preliminary in view of the retrospective and nonrandomized nature of this studv. (c) 2006 American Society for Blood and Marrow Transplantation.