Sano H, Kobayashi R, Iguchi A, Suzuki D, Kishimoto K, Yasuda K, Kobayashi K
Department of Pediatrics, Sapporo Hokuyu Hospital, Sapporo, Japan.
Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Bone Marrow Transplant. 2014 Jan;49(1):38-41. doi: 10.1038/bmt.2013.123. Epub 2013 Aug 19.
Idiopathic pneumonia syndrome (IPS) is a critical complication following allogeneic hematopoietic SCT (HSCT); however, few reports have analyzed the risk factors for IPS in children. A total of 210 consecutive pediatric patients, including 131 boys and 79 girls, with various hematologic malignancies, aplastic anemia or solid tumors who underwent allogeneic HSCT were analyzed to clarify the incidence and risk factors for IPS. Patient and transplantation characteristics after allogeneic HSCT were compared between patients with and without IPS. Cumulative incidence rates of IPS 120 days after allogeneic HSCT were 6.7% (14/210). Of 14 patients with IPS, 11 (78.6%) died after developing IPS. The presence of prior HSCT was more frequent in patients with IPS (IPS group) than in those without IPS (non-IPS group; 35.7 vs 12.8%, respectively, P=0.018). The IPS group contained more patients with acute GVHD (grade II-IV) than the non-IPS group (50.0 vs 18.9%, respectively, P=0.006). The association of these two factors with IPS was further confirmed by multivariate analysis. We should be aware of these risk factors in patients who have undergone allogeneic HSCT.
特发性肺炎综合征（IPS）是异基因造血干细胞移植（HSCT）后的一种严重并发症；然而，很少有报告分析儿童IPS的危险因素。本研究分析了210例连续接受异基因HSCT的儿科患者，包括131名男孩和79名女孩，他们患有各种血液系统恶性肿瘤、再生障碍性贫血或实体瘤，以明确IPS的发病率和危险因素。比较了发生IPS和未发生IPS的患者在异基因HSCT后的患者及移植特征。异基因HSCT后120天IPS的累积发病率为6.7%（14/210）。14例IPS患者中，11例（78.6%）在发生IPS后死亡。IPS患者（IPS组）中既往有HSCT史的比例高于无IPS患者（非IPS组；分别为35.7%和12.8%，P=0.018）。IPS组中急性移植物抗宿主病（II-IV级）的患者比非IPS组多（分别为50.0%和18.9%，P=0.006）。多因素分析进一步证实了这两个因素与IPS的相关性。对于接受异基因HSCT的患者，我们应该了解这些危险因素。
