Department of Pediatrics, Medicine and Pathology, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University, New York, NY 10032, USA.
Bone Marrow Transplant. 2011 Apr;46(4):529-38. doi: 10.1038/bmt.2010.149. Epub 2010 Jun 28.
The objective of this study was to assess the incidence, risk factors, outcome and impact on OS of pericardial effusion (PEF) in a cohort of 156 pediatric SCT recipients. The mean age was 8.15±6.25 years. In all, 74% of the patients had malignant disease and 35% of the patients received autologous stem cell grafts. Twenty-three subjects developed effusion at 2.75±3.54 months after SCT. The overall probability of developing a PEF after SCT was 16.9%. In the multivariate analysis of risk factors associated with time to PEF, increased age, allogeneic risk status and conditioning type, were all significant factors. In a multivariate analysis of time to death, PEF, CMV status and risk status were all independent risk factors. PEF, however, had the highest HR of 3.334. Of the 23 patients with PEF, 19 died (82.6%); however, none died as a direct result of pericardial tamponade. In summary, our results suggest that PEF is a significant risk factor for post transplant mortality. These results suggest a need for more frequent evaluation and monitoring for development of PEF. Studies are needed to determine the etiology of, and new therapeutic strategies for, PEF in the post-SCT population.
本研究旨在评估 156 例儿科 SCT 受者心包积液 (PEF) 的发生率、危险因素、结局和对 OS 的影响。平均年龄为 8.15±6.25 岁。所有患者中有 74%患有恶性疾病，35%的患者接受了自体干细胞移植。23 例患者在 SCT 后 2.75±3.54 个月出现积液。SCT 后发生 PEF 的总体概率为 16.9%。在对与 PEF 发生时间相关的危险因素进行多因素分析时，年龄增大、异体风险状态和预处理类型均为显著因素。在对死亡时间、PEF、CMV 状态和风险状态进行多因素分析时，PEF 均为独立的危险因素。然而，PEF 的 HR 最高，为 3.334。在 23 例有 PEF 的患者中，19 例死亡（82.6%）；然而，没有一例是直接由于心包填塞而死亡。总之，我们的结果表明，PEF 是移植后死亡的一个重要危险因素。这些结果表明，需要更频繁地评估和监测 PEF 的发生。需要研究来确定 SCT 后人群中 PEF 的病因和新的治疗策略。
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