儿童造血干细胞移植：意大利儿科学血液肿瘤协会（AIEOP）骨髓移植组报告

Hematopoietic stem cell transplantation in childhood: report from the bone marrow transplantation group of the Associazione Italiana Ematologia Oncologia Pediatrica (AIEOP).

作者信息

Pession A, Rondelli R, Paolucci P, Pastore G, Dini G, Bonetti F, Madon E, Mandelli F, Zanesco L, Uderzo C, Prete A, Rabusin M, Ugazio A, Di Bartolomeo P, Favre C, Bojd-Faulkner L, Poggi V, Luksch R, Donfrancesco A, Argiolu F, La Nasa G, Amici A, Locatelli F

机构信息

Department of Pediatrics, University of Bologna, Ospedle Sant'Orsola, Bologna, Italy.

出版信息

Haematologica. 2000 Jun;85(6):638-46.

PMID:10870122

Abstract

BACKGROUND AND OBJECTIVE

Transplantation of hematopoietic stem cells from different sources is being increasingly used to treat a variety of diseases in children. Transplant procedures and indications have changed considerably during recent years. Monitoring of information about these changes is useful for interpretation of nationwide collected data.

DESIGN AND METHODS

Since 1985, Centers belonging to the AIEOP (Associazione Italiana Ematologia Oncologia Pediatrica), performing hematopoietic stem cell transplants (HSCT) in children, and members of the AIEOP-Bone Marrow Transplant (BMT) Group annually report data on their transplant activity to the AIEOP-BMT Registry employing specially prepared patient-oriented forms.

RESULTS

From January 1985 to December 1998, a total of 2,474 bone marrow (BM), peripheral blood (PB) or umbilical cord blood (CB) transplants were reported: 1,296 (52%) were allogeneic (Allo) and 1,178 (48%) autologous (Auto) transplants. These transplants were performed in 19 Italian Centers on 2,249 patients aged less than 17 years. Among Allo-transplants, 1,198 (92%) were performed using BM progenitor cells, whereas 49 (4%) CB, 42 (3%) were PB, 4 BM plus PB, and 3 BM plus CB allografts; they were performed using HLA-identical sibling donors in 867 cases (67%) and alternative donors (i.e. partially-matched relatives or unrelated donors) in the remaining 429 (33%) cases. Allogeneic transplants were performed on 786 (67%) patients with malignancy and on 395 (33%) patients with non-malignant disorders. In the last 6 years, the number of Allo-transplants per year exceeded that of Auto-transplants. Of the Auto-transplants, 775 (66%) were performed using BM, and 403 (34%) using PB alone or combined with BM hematopoietic stem cells. Indications for Auto-BMT were myelo-lymphoproliferative disorders in 524 (49%) cases, solid tumor in 533 (50%) cases and non-malignant disease in 11 (1%) cases. In the last 5 years, the use of PB for autografts has increased from 7% to 70%.

INTERPRETATION AND CONCLUSIONS

These data reflect the development and present status of HSCT in Italy and provide a basis for patient counseling and health care planning.

摘要

背景与目的

不同来源的造血干细胞移植正越来越多地用于治疗儿童的各种疾病。近年来，移植程序和适应症发生了很大变化。监测这些变化的信息有助于解读全国范围内收集的数据。

设计与方法

自1985年以来，意大利儿童血液肿瘤学会（AIEOP）下属进行儿童造血干细胞移植（HSCT）的中心以及AIEOP骨髓移植（BMT）小组的成员每年使用专门编制的面向患者的表格向AIEOP-BMT登记处报告其移植活动数据。

结果

1985年1月至1998年12月，共报告了2474例骨髓（BM）、外周血（PB）或脐带血（CB）移植：1296例（52%）为异基因（Allo）移植，1178例（48%）为自体（Auto）移植。这些移植在19个意大利中心对2249例17岁以下患者进行。在异基因移植中，1198例（92%）使用骨髓祖细胞进行，而49例（4%）使用脐带血，42例（3%）使用外周血，4例为骨髓加外周血，3例为骨髓加脐带血同种异体移植；867例（67%）使用人类白细胞抗原（HLA）相同的同胞供体，其余429例（33%）使用替代供体（即部分匹配的亲属或无关供体）。786例（67%）恶性疾病患者和395例（33%）非恶性疾病患者接受了异基因移植。在过去6年中，每年异基因移植的数量超过自体移植。在自体移植中，775例（66%）使用骨髓，403例（34%）单独使用外周血或与骨髓造血干细胞联合使用。自体骨髓移植的适应症为骨髓增殖性疾病524例（49%）、实体瘤533例（50%）和非恶性疾病11例（1%）。在过去5年中，外周血用于自体移植的比例从7%增加到70%。