Garaventa A, Porta F, Rondelli R, Dini G, Meloni G, Bonetti F, Uderzo C, De Manzini A, Miniero R, Brutti F
Department of Hematology/Oncology, Giannina Gaslini Istitute, Genova, Italy.
Bone Marrow Transplant. 1992 Nov;10(5):419-23.
In order to determine the incidence and causes of death during the first 100 days after BMT (early deaths) in a pediatric population we have examined data reported in the AIEOP BMT Registry. Up to July 1990, data on 486 children who underwent allogeneic (180) or autologous (306) BMT were evaluable. The children had acute lymphoblastic leukemia (148 cases), acute non-lymphoblastic leukemia (127 cases), neuroblastoma (82 cases), chronic myelogenous leukemia (15 cases), aplastic anemia (nine cases), solid tumors, lymphoma, immunodeficiency or storage diseases. The overall survival is 55% for allogeneic HLA matched and 38% for autologous transplants at 5 years, 24% for HLA mismatched graft at 2 years. Out of the 486 children, 70 (14%) died during the first 100 days after BMT: 33/306 (11%) after autologous BMT, 24/150 (16%) after allogeneic matched BMT and 13/30 (43%) after mismatched BMT. Causes of early death were as follows: disease progression: 12 children (10/306 after autologous and 2/180 after allogeneic BMT); infection: 12 children (five after autologous and seven after allogeneic BMT); interstitial pneumonitis: 21 children (seven after autologous and 14 after allogeneic BMT); cardiac failure: five children (four after autologous BMT); veno-occlusive disease: eight children (three after autologous, five after allogeneic BMT); acute renal failure: three children (one after autologous and two after allogeneic BMT); multiple organ failure: two cases (one after autologous BMT); cerebral hemorrhage: three children (one after autologous BMT); hypertension: one child; acute GVHD: three children (12% of early deaths after allogeneic BMT).
为了确定儿科人群中骨髓移植（BMT）后前100天内的死亡率及死亡原因（早期死亡），我们研究了意大利儿童血液学和肿瘤学协作组（AIEOP）BMT登记处报告的数据。截至1990年7月，486例接受异基因（180例）或自体（306例）BMT的儿童数据可进行评估。这些儿童患有急性淋巴细胞白血病（148例）、急性非淋巴细胞白血病（127例）、神经母细胞瘤（82例）、慢性粒细胞白血病（15例）、再生障碍性贫血（9例）、实体瘤、淋巴瘤、免疫缺陷或贮积病。异基因HLA配型相合移植5年总生存率为55%，自体移植为38%；HLA配型不相合移植2年总生存率为24%。在这486例儿童中，70例（14%）在BMT后前100天内死亡：自体BMT后33/306例（11%），异基因配型相合BMT后24/150例（16%），配型不相合BMT后13/30例（43%）。早期死亡原因如下：疾病进展：12例儿童（自体BMT后10/306例，异基因BMT后2/180例）；感染：12例儿童（自体BMT后5例，异基因BMT后7例）；间质性肺炎：21例儿童（自体BMT后7例，异基因BMT后14例）；心力衰竭：5例儿童（自体BMT后4例）；静脉闭塞性疾病：8例儿童（自体BMT后3例，异基因BMT后5例）；急性肾衰竭：3例儿童（自体BMT后1例，异基因BMT后2例）；多器官功能衰竭：2例（自体BMT后1例）；脑出血：3例儿童（自体BMT后1例）；高血压：1例儿童；急性移植物抗宿主病：3例儿童（异基因BMT后早期死亡的12%）。
