Decision analysis of allogeneic bone marrow transplantation versus immunosuppressive therapy for young adult patients with aplastic anemia
Decision analysis of allogeneic bone marrow transplantation versus immunosuppressive therapy for young adult patients with aplastic anemia
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青年再生障碍性贫血患者同种异体骨髓移植与免疫抑制治疗的决策分析
DOI：
10.1007/s12185-022-03530-6
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发表时间：
2023
影响因子：
2.1
通讯作者：
Yamazaki Hirohito
中科院分区：
文献类型：
--
作者：
Kanda Yoshinobu;Usuki Kensuke;Inagaki Mitsuhiro;Ohta Akiko;Ogasawara Yoji;Obara Naoshi;Kako Shinichi;Kurokawa Mineo;Shimada Naoki;Suzuki Takahiro;Hama Asahito;Yamaguchi Hiroki;Nakao Shinji;Yamazaki Hirohito
背景来自HLA相合同胞供者的异基因骨髓移植（BMT）被推荐作为年轻患者的初始治疗。然而，免疫抑制治疗（IST）与环孢素和抗胸腺细胞球蛋白可能是一个可行的选择，即使当HLA-相同的同胞donoris.MethodsWe构建了一个马尔可夫模型，以模拟10年的临床病程的患者年龄在21-40岁，新诊断的重型再生障碍性贫血。假设有HLA相同的同胞供体，将立即BMT和IST作为初始治疗进行比较。治疗后的转移概率确定的基础上登记数据分析BMT和一个长期的前瞻性研究IST.ResultsQuality-adjusted生命年（Qs）治疗选择后分别为6.77 BMT和6.74 IST。单向敏感性分析显示，效用是活的BMT后，没有GVHD，是活的IST后的部分反应，和初始IST后的反应率强烈影响result.ConclusionsBMT和IST产生类似的QALY的年轻患者严重再生障碍性贫血。对初始IST的响应率的估计可以实现BMT和IST之间的个体化比较。
BackgroundAllogeneic bone marrow transplantation (BMT) from an HLA-matched sibling donor is recommended as an initial treatment for young patients. However, immunosuppressive therapy (IST) with cyclosporine and anti-thymocyte globulin may be a viable option even when an HLA-identical sibling donor is available.MethodsWe constructed a Markov model to simulate the 10-year clinical course of patients aged 21–40 years with newly diagnosed severe aplastic anemia. Immediate BMT and IST were compared as an initial treatment assuming the availability of an HLA-identical sibling donor. Transition probabilities after treatment were determined based on a registry data analysis for BMT and a long-term prospective study for IST.ResultsQuality-adjusted life years (QALYs) after treatment selection were 6.77 for BMT and 6.74 for IST. One-way sensitivity analysis revealed that the utility for being alive without GVHD after BMT, that for being alive with partial response after IST, and the response rate after initial IST strongly affected the results.ConclusionsBMT and IST produced similar QALY for young patients with severe aplastic anemia. An estimation of the response rate to the initial IST may enable an individualized comparison between BMT and IST.
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美国国立卫生研究院标准对日本队列中晚期急性和慢性移植物抗宿主病的发病率、治疗和生存进行的前瞻性纵向观察。
影响因子：
4.3
作者：
C. Ohwada;E. Sakaida;A. Igarashi;Takeshi Kobayashi;N. Doki;T. Mori;Jun Kato;Y. Koda;H. Kanamori;Masatsugu Tanaka;T. Tachibana;S. Fujisawa;Y. Nakajima;A. Numata;M. Toyosaki;Yasuyuki Aoyama;M. Onizuka;M. Hagihara;S. Koyama;Y. Kanda;H. Nakasone;H. Shimizu;S. Kato;R. Watanabe;Katsuhiro Shono;R. Sakai;Takeshi Saito;C. Nakaseko;S. Okamoto
通讯作者：
S. Okamoto
影响因子：
4.3
作者：
Buchbinder, David;Nugent, Diane J.;Brazauskas, Ruta;Wang, Zhiwei;Aljurf, Mahmoud D.;Cairo, Mitchell S.;Chow, Robert;Duncan, Christine;Eldjerou, Lamis K.;Gupta, Vikas;Hale, Gregory A.;Halter, Joerg;Hayes-Lattin, Brandon M.;Hsu, Jack W.;Jacobsohn, David A.;Kamble, Rammurti T.;Kasow, Kimberly A.;Lazarus, Hillard M.;Mehta, Paulette;Myers, Kasiani C.;Parsons, Susan K.;Passweg, Jakob R.;Pidala, Joseph;Reddy, Vijay;Sales-Bonfim, Carmen M.;Savani, Bipin N.;Seber, Adriana;Sorror, Mohamed L.;Steinberg, Amir;Wood, William A.;Wall, Donna A.;Winiarski, Jacek H.;Yu, Lolie C.;Majhail, Navneet S.
通讯作者：
Majhail, Navneet S.
影响因子：
45.3
作者：
Koreth, John;Pidala, Joseph;Cutler, Corey
通讯作者：
Cutler, Corey
影响因子：
4.8
作者：
Yokota, A.;Ozawa, S.;Okamoto, S.
通讯作者：
Okamoto, S.
影响因子：
4.3
作者：
Kako, Shinichi;Yamazaki, Hirohito;Mori, Takehiko
通讯作者：
Mori, Takehiko