Venous Thromboembolism in Autologous Blood or Marrow Transplantation Survivors: A Report from the Blood or Marrow Transplant Survivor Study.
Venous Thromboembolism in Autologous Blood or Marrow Transplantation Survivors: A Report from the Blood or Marrow Transplant Survivor Study.
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自体血液或骨髓移植幸存者的静脉血栓栓塞：血液或骨髓移植幸存者研究报告。
DOI：
10.1016/j.bbmt.2019.06.032
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Bhatia,Smita
中科院分区：
文献类型：
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作者：
Gangaraju,Radhika;Chen,Yanjun;Hageman,Lindsey;Wu,Jessica;Francisco,Liton;Battles,Kevin;Kung,Michelle;Ness,Emily;Parman,Mariel;Weisdorf,DanielJ;Forman,StephenJ;Arora,Mukta;Armenian,SaroH;Bhatia,Smita
止血并发症是血液或骨髓移植（BMT）受者常见的并发症，增加了他们的发病率和死亡率，并在移植后立即进行了充分的描述。自体骨髓移植长期存活者发生静脉血栓栓塞（VTE）的风险以前没有研究过。对1974年1月1日至2010年12月31日期间因恶性血液病接受自体BMT、移植后存活2年或更长时间、年龄≥18岁的患者进行长期结局调查。中位随访时间为9.8年（四分位距，6.4 - 14.3年）。我们分析了820例存活≥2年的自体骨髓移植受者的VTE风险，并与644例同胞进行了比较。在调整社会人口学特征后，BMT幸存者发生静脉血栓栓塞的风险是同胞的2.6倍（95%置信区间[CI]，1.6 - 4.4;P=.0004）。在BMT后生存≥2年的条件下，5年时VTE的平均累积发生率为3.9 ± .8%，10年时为6.1 ± 1.1%。浆细胞疾病的诊断（风险比[HR]，2.37; 95%CI，1.3 - 4.2;P= 0.004）和家庭年收入≤ 50，000美元（HR，2.02; 95%CI，1.2 - 3.6;P= 0.015）与VTE风险增加相关。我们的数据表明，自体BMT幸存者发生迟发性静脉血栓栓塞的风险较高。风险预测模型的发展，以确定自体骨髓移植幸存者在最大的风险，静脉血栓栓塞和血栓预防可能有助于降低发病率和死亡率与静脉血栓栓塞。
Hemostatic complications are commonly encountered in blood or marrow transplantation (BMT) recipients, increasing their morbidity and mortality and are well described in the immediate post-transplantation period. The risk of venous thromboembolism (VTE) in long-term survivors of autologous BMT has not been studied previously. Patients who underwent autologous BMT between January 1, 1974, and December 31, 2010 for a hematologic malignancy, lived 2 years or more after transplantation, and were age ≥18 years were surveyed for long-term outcomes. The median duration of follow-up was 9.8 years (interquartile range, 6.4 to 14.3 years). We analyzed the risk of VTE in 820 autologous BMT recipients who survived for ≥2 years, compared with 644 siblings. BMT survivors were at a 2.6-fold higher risk of VTE compared with siblings (95% confidence interval [CI], 1.6 to 4.4;P=.0004), after adjusting for sociodemographic characteristics. Conditional on surviving for ≥2 years after BMT, the mean cumulative incidence of VTE was 3.9 ± .8% at 5 years and 6.1 ± 1.1% at 10 years. A diagnosis of plasma cell disorder (hazard ratio [HR], 2.37; 95% CI, 1.3 to 4.2;P= .004) and annual household income ≤$50,000 (HR, 2.02; 95% CI, 1.2 to 3.6;P= .015) were associated with increased VTE risk. Our data indicate that autologous BMT survivors are at elevated risk for developing late-occurring VTE. The development of risk prediction models to identify autologous BMT survivors at greatest risk for VTE and thromboprophylaxis may help decrease the morbidity and mortality associated with VTE.