Characteristics and risk factors of oral mucositis after allogeneic stem cell transplantation with FLU/MEL conditioning regimen in context with BU/CY2
Characteristics and risk factors of oral mucositis after allogeneic stem cell transplantation with FLU/MEL conditioning regimen in context with BU/CY2
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DOI：
10.1038/bmt.2009.66
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发表时间：
2009-11-01
影响因子：
4.8
通讯作者：
Koza, V.
中科院分区：
文献类型：
--
作者：
Vokurka, S.;Steinerova, K.;Koza, V.
对氟达拉滨(Flu)/马法兰(Mel)联合大剂量氟达拉滨(Flu)/马法兰(Mel)方案和BU/Cy2方案进行对比分析，以了解口腔粘膜炎(OM)的特征和危险因素。BU/Cy2和Flu/MEL的OM发生率差异有统计学意义(100vs78%，P=0.004)，但重度OM的发生率在3~4WHO和OM动力学方面完全相似。OM持续时间在+21天的患者发生急性移植物抗宿主病的比例较高(68vs32%，P=0.005)，且往往较无持续时间的患者更早发生。多因素分析显示，急性移植物抗宿主病与OM的严重程度和持续时间显著相关，OM的严重程度与其持续时间显著相关。在Flu/MEL方案中，基于体表面积的剂量导致每公斤体重给予的MEL剂量范围很大(2.5-5.2毫克/公斤，中位数3.5)。在多变量分析中，每公斤体重的MEL剂量被发现是OM发生率和严重性的显著预测因素。女性性别和较低的体重指数不是那么重要的变量，而不是这样一个事实，即按体表面积计算时，每公斤体重实际给予的MEL剂量相对较高。骨髓移植(2009年)44601-605；DOI：10.1038/bmt.2009.66；在线发布
The fludarabine ( FLU)/melphalan (MEL) conditioning regimen containing FLU and high-dose MEL was analyzed in comparison with the BU/CY2 regimen to characterize oral mucositis ( OM) and risk factors. OM incidence significantly varied between BU/CY2 and FLU/ MEL ( 100 vs 78%, P = 0.004), but the incidence of severe OM grades 3-4 WHO and kinetics of OM were fully comparable. Patients with OM persisting on day +21 had more acute GVHD (68 vs 32%, P = 0.005), which tended to occur earlier than among those without such prolonged OM. Multivariate analysis showed significant dependency of acute GVHD on severity and prolonged duration of OM and significant correlation between OM severity and its prolonged duration. Body surface area-based dosing in the FLU/ MEL regimen led to a wide range of MEL doses administered per kilogram body weight (2.5-5.2 mg/kg, median 3.5). In multivariate analysis, MEL dose per kilogram of body weight was found to be a significant predictor of OM incidence and severity. Female gender and lower body mass index were less important variables than the fact that the actual dose of MEL administered per kilogram of body weight was relatively high when the dosage was calculated on the basis of body surface area. Bone Marrow Transplantation ( 2009) 44, 601-605; doi: 10.1038/bmt.2009.66; published online 6 April 2009