Kawasaki Keiichiro, Kosaka Yoshiyuki, Nakamura Hajime
Division of Pediatrics, Department of Development and Aging, Kobe University Graduate School of Medicine.
Kobe J Med Sci. 2003;49(1-2):1-10.
A retrospective analysis of the clinical features of 62 patients with various hematological or other diseases who received allogeneic stem cell transplantation (SCT) between April 1990 and July 2002 in the Department of Pediatrics, Kobe University Hospital was conducted to investigate prognostic factors of allo-SCT. Among 62 allo-SCT, 51 (82%) were bone marrow transplantation (BMT), 5 (8%) were peripheral blood stem cell transplantation and 6 (10%) were cord blood transplantation. Disease-free survival rate (DFS) estimated according to the diagnosis group did not show any significant difference. For hematological malignant diseases, DFS estimated according to the disease stage was 66.7% for the patients in the standard stage and 30.0% for the patients in the advanced stage (p=0.0249). Of 47 evaluable patients receiving allo-BMT, DFS of patients receiving the last transfusion of platelets on or before day 21 was significantly higher than that of patients receiving the last transfusion after day 21 (66.7% vs 34.8%, p=0.0111). These results demonstrate that more appropriate indications and points for SCT should be applied to patients in the advanced stage, and that whether the last transfusion of platelet is on or before or after day 21 is an important prognostic factor for allo-BMT because the necessity for platelet transfusion was vividly reflected in the status of the patients.
对1990年4月至2002年7月间在神户大学医院儿科接受异基因干细胞移植（SCT）的62例患有各种血液系统疾病或其他疾病的患者的临床特征进行回顾性分析，以研究异基因SCT的预后因素。在62例异基因SCT中，51例（82%）为骨髓移植（BMT），5例（8%）为外周血干细胞移植，6例（10%）为脐血移植。根据诊断组估算的无病生存率（DFS）未显示出任何显著差异。对于血液系统恶性疾病，根据疾病分期估算的DFS，处于标准期的患者为66.7%，处于晚期的患者为30.0%（p = 0.0249）。在47例可评估的接受异基因BMT的患者中，在第21天或之前接受最后一次血小板输注的患者的DFS显著高于在第21天后接受最后一次血小板输注的患者（66.7%对34.8%，p = 0.0111）。这些结果表明，对于晚期患者应采用更合适的SCT适应症和要点，并且血小板最后一次输注是在第21天之前还是之后是异基因BMT的一个重要预后因素，因为血小板输注的必要性在患者状况中得到了生动体现。
