造血干细胞移植后硬皮病样慢性移植物抗宿主病的临床表现

发布时间：2018-06-30 10:00

本文选题：造血干细胞移植 + 硬皮病样移植物抗宿主病　；参考：《南方医科大学学报》2016年06期

【摘要】：目的探讨异基因造血干细胞移植(allo-HSCT)后硬皮病样慢性移植物抗宿主病(Sc GVHD)的发病率、危险因素。方法对我院2012年1月~2014年12月之间进行allo-HSCT的259例患者发生Sc GVHD的情况进行回顾性分析。结果 134例(51.7%)发生慢性移植物抗宿主病(c GVHD),其中22例为硬皮病型,即Sc GVHD在移植患者中的发病率为8.49%(22/259)、在c GVHD患者中的发病率为16.4%(22/134)。Sc GVHD出现的中位时间为移植后12.5(4~28)月。单因素分析结果提示预处理方案是否含全身照射(TBI)(P=0.031)、GVHD预防方案是否含霉酚酸酯(MMF)(P=0.046)、c GVHD(P=0.008)的发生、供者淋巴细胞回输(DLI)(P=0.001)均与Sc GVHD的发生具有相关性。多因素分析确定c GVHD[相对危险度(RR)=3.512,95%可信区间(CI)=1.235~9.987,P=0.018]和DLI(RR=5.217,95%CI=1.698~16.029,P=0.004)为Sc GVHD发病的独立危险因素。结论Sc GVHD是移植后一种较为少见的并发症,移植物抗宿主病(GVHD)和DLI是其发病的独立危险因素。
[Abstract]:Objective to investigate the incidence and risk factors of chronic graft versus host disease (SC GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods A retrospective analysis of SC GVHD was performed in 259 patients with allo-HSCT from January 2012 to December 2014. Results chronic graft-versus-host disease (c GVHD) occurred in 134 cases (51.7%), of which 22 cases were scleroderma type, the incidence of SC GVHD was 8.49% (22 / 259) in transplant patients and 16.4% (22 / 134) in c GVHD patients. The median time of occurrence of Sc GVHD was 12.5 (42 / 28) months after transplantation. The results of univariate analysis showed that whether the pretreatment regimen included TBI (P0.031) or GVHD (MMF) (P0. 046) / c GVHD (P0. 008) was associated with the occurrence of SC GVHD. Donor lymphocyte reinfusion (DLI) (P0. 001) was associated with the occurrence of SC GVHD. Multivariate analysis confirmed that c GVHD [relative risk (RR) 3.512 95% confidence interval (CI) 1.235 ~ 9.987%] and DLI (RRGVHD 5.21795CII 1.69816.029P0.004) were independent risk factors of SC GVHD. Conclusion Sc GVHD is a rare complication after transplantation. GVHD and DLI are independent risk factors.
【作者单位】：南方医科大学南方医院血液科//血液病研究所;
【基金】：广州市健康医疗协同创新重大专项(201400000003-4)
【分类号】：R457.7

【相似文献】