Human leukocyte antigen 7/8-matched unrelated bone marrow transplantation using anti-thymocyte globulin in children

Human leukocyte antigen 7/8-matched unrelated bone marrow transplantation using anti-thymocyte globulin in children
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儿童使用抗胸腺细胞球蛋白进行人类白细胞抗原7/8匹配的无关骨髓移植

DOI:
10.1007/s12185-023-03571-5
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发表时间:
2023
影响因子:
2.1
通讯作者:
Ito Yoshinori
Ito Yoshinori
中科院分区:
医学4区
文献类型:
--
作者:
Hamada Motoharu;Muramatsu Hideki;Torii Yuka;Suzuki Kyogo;Narita Atsushi;Yoshida Taro;Imaya Masayuki;Yamamori Ayako;Wakamatsu Manabu;Miwata Shunsuke;Narita Kotaro;Kataoka Shinsuke;Kawashima Nozomu;Taniguchi Rieko;Nishikawa Eri;Nishio Nobuhiro;Ito Yoshinori

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人类白细胞抗原(HLA)不匹配的无关供体移植与移植物抗宿主病、移植物衰竭和感染的风险增加相关,这增加了移植后的发病率和死亡率。在这项单中心回顾性研究中,对30名连续接受HLA 1等位基因不匹配(HLA 7/8匹配)无关供体骨髓移植(BMT)的儿童进行了结局评价,并使用兔抗胸腺细胞球蛋白(rATG)预防移植物抗宿主病(GVHD)。3年总生存率(OS)、无事件生存率(EFS)和GVHD无复发生存率分别为91.7%(95%CI 70.5%-91.9%)、88.3%(95%CI 67.5%-96.1%)和73.9%(95%CI 52.4%-86.8%)。II-IV级和III-IV级急性GVHD分别发生在10例(33%)和2例(7.0%)患者中。慢性GVHD的3年累积发生率为7.8%。未发生致死性病毒感染。研究结果表明,HLA 7/8相合的无关BMT与ATG联合移植可获得良好的结局和可接受的GVHD,特别是对于缺乏完全相合供者的患者。
Human leukocyte antigen (HLA) mismatched unrelated donor transplantation is associated with an increased risk of graft-versus-host disease, graft failure, and infection, which increases post-transplant morbidity and mortality. In this single-center retrospective study, outcomes were evaluated in 30 consecutive children who underwent bone marrow transplantation (BMT) from HLA 1 allele-mismatched (HLA 7/8-matched) unrelated donors with rabbit anti-thymocyte globulin (rATG) as graft-versus-host disease (GVHD) prophylaxis. The 3-year overall survival (OS), event-free survival (EFS), and GVHD-relapse-free survival rates were 91.7% (95% CI 70.5%–91.9%), 88.3% (95% CI 67.5%–96.1%), and 73.9% (95% CI 52.4%–86.8%), respectively. Grade II–IV and III–IV acute GVHD occurred in 10 (33%) and 2 (7.0%) patients, respectively. The 3-year cumulative incidence of chronic GVHD was 7.8%. No fatal viral infections occurred. The study results show the feasibility of HLA 7/8-matched unrelated BMT with ATG to achieve favorable outcomes and acceptable GVHD, especially for patients who lack a fully matched donor.
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发表时间: 2020-08-25
期刊: BLOOD ADVANCES
影响因子: 7.5
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期刊:
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