Toda Akinari, Takatsuka Hiroyuki, Nakajima Toshiyuki, Nomura Kaori, Wakae Takeshi, Itoi Hisayuki, Okada Masaya, Misawa Mahito, Hara Hiroshi
Division of Hematology, Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan.
Hematology. 2007 Feb;12(1):29-31. doi: 10.1080/10245330600938224.
The severity of graft-versus-host disease (GVHD) was compared after cord blood transplantation (CBT) and bone marrow transplantation (BMT). The severity of GVHD was also analyzed in relation to serum elastase and antithrombin-3 (AT-3) levels. There was no significant difference in the average grade of acute GVHD between 49 BMT patients and 20 CBT patients (chi2-test). However, there was a lower incidence of patients without acute GVHD (grade 0) or patients with severe acute GVHD (grade 3 or 4) in CBT compared with BMT group. Linear regression analysis found no significant correlation between the serum elastase level and the grade of acute GVHD, between the serum AT-3 level and the grade of acute GVHD, or between the serum levels of elastase and AT-3 before conditioning and after engraftment. The AT-3 level after engraftment was significantly higher in the CBT group than in the BMT group and it did not fail along with the elevation of elastase in the CBT group (p < 0.01 by the Mann-Whitney U-test vs. the BMT group). In conclusion, the lower risk of severe acute GVHD in the CBT group may have been related to the smaller decrease of AT-3 after transplantation.
对脐带血移植（CBT）和骨髓移植（BMT）后移植物抗宿主病（GVHD）的严重程度进行了比较。还分析了GVHD严重程度与血清弹性蛋白酶和抗凝血酶-3（AT-3）水平的关系。49例BMT患者和20例CBT患者的急性GVHD平均分级无显著差异（卡方检验）。然而，与BMT组相比，CBT组中无急性GVHD（0级）或严重急性GVHD（3级或4级）患者的发生率较低。线性回归分析发现，血清弹性蛋白酶水平与急性GVHD分级之间、血清AT-3水平与急性GVHD分级之间，以及预处理前和植入后弹性蛋白酶和AT-3的血清水平之间均无显著相关性。CBT组植入后的AT-3水平显著高于BMT组，且在CBT组中其水平并未随弹性蛋白酶的升高而下降（与BMT组相比，曼-惠特尼U检验p < 0.01）。总之，CBT组严重急性GVHD风险较低可能与移植后AT-3下降幅度较小有关。
