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儿童自体干细胞移植中培非格司亭的应用:配对分析。

Palifermin in children undergoing autologous stem cell transplantation: a matched-pair analysis.

机构信息

Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.

Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland

出版信息

Anticancer Res. 2014 Dec;34(12):7379-82.

Abstract

BACKGROUND

Keratinocyte growth factor (palifermin) is used for prevention of mucositis in adults following autologous and allogeneic hematopoietic stem cell transplantation (HSCT). It is known that palifermin decreases length of initial hospital stay, mean number of days of total parenteral nutrition (TPN) and the use of opioids for pain control in oral mucositis in adults. There are limited data evaluating palifermin use in children following autologous HSCT.

AIM

The objective of the present study was the analysis of efficacy and safety of palifermin in children undergoing auto-HSCT.

PATIENTS AND METHODS

This matched-pair analysis study included 62 pediatric patients undergoing first auto-HSCT receiving palifermin on a compassionate-use basis (study group, n=31) or not (control group, n=31).

RESULTS

Palifermin decreased the incidence of severe (grade 3-4 WHO) oral mucositis (p=0.041), length of hospitalization (p=0.047) and contributed to the shorter duration of oral mucositis (p=0.035) and lower incidence of clinically or microbiologically documented infections (p=0.038). There were no differences between groups in opioid use, neutrophil and platelet recovery, TPN use and gastrointestinal hemorrhage.

CONCLUSION

Palifermin decreases the incidence and severity of oral mucositis in children undergoing autologous HSCT.

摘要

背景

角质细胞生长因子(培非格司亭)用于预防自体和异基因造血干细胞移植(HSCT)后成人的粘膜炎。已知培非格司亭可减少成人粘膜炎初始住院时间、总肠外营养(TPN)天数和阿片类药物用于疼痛控制的中位数。关于培非格司亭在自体 HSCT 后儿童中的应用,数据有限。

目的

本研究旨在分析培非格司亭在接受自体 HSCT 的儿童中的疗效和安全性。

患者和方法

这项配对分析研究纳入了 62 名接受首次自体 HSCT 的儿科患者,他们接受了培非格司亭的同情使用(研究组,n=31)或未接受(对照组,n=31)。

结果

培非格司亭降低了严重(WHO 3-4 级)口腔粘膜炎的发生率(p=0.041)、住院时间(p=0.047),并有助于缩短口腔粘膜炎的持续时间(p=0.035)和降低临床或微生物学确诊感染的发生率(p=0.038)。两组在阿片类药物使用、中性粒细胞和血小板恢复、TPN 使用和胃肠出血方面无差异。

结论

培非格司亭可降低接受自体 HSCT 的儿童口腔粘膜炎的发生率和严重程度。

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