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去纤苷预防能否降低异基因造血细胞移植后急性移植物抗宿主病的风险?

Does defibrotide prophylaxis decrease the risk of acute graft versus host disease following allogeneic hematopoietic cell transplantation?

作者信息

Tekgündüz Emre, Kaya Ali Hakan, Bozdağ Sinem Civriz, Koçubaba Şerife, Kayıkçı Ömür, Namdaroğlu Sinem, Uğur Bilge, Akpınar Seval, Batgi Hikmetullah, Bekdemir Filiz, Altuntaş Fevzi

机构信息

Ankara Oncology Education and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey.

Ankara Oncology Education and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey.

出版信息

Transfus Apher Sci. 2016 Feb;54(1):30-4. doi: 10.1016/j.transci.2016.01.009. Epub 2016 Jan 12.

DOI:10.1016/j.transci.2016.01.009
PMID:26922995
Abstract

There is some preliminary evidence, that veno-occlusive disease prophylaxis with defibrotide (DF) may also have a role in decreasing risk of acute graft-versus-host disease (aGvHD) by preventing tissue damage. In this study, we aimed to investigate the role of DF prophylaxis on the development of aGvHD at D+180. One hundred ninety-five consecutive adult patients receiving allogeneic HCT were retrospectively evaluated in 3 groups: no DF, DF/post-HCT (DF D+1 to D+14) and DF/pre-HCT (DF for 14 days concurrently with conditioning). The total (p: 0.057) and grades III/IV (p: 0.051) aGvHD rates at D+180 were 46.5%, 40%, 25.5% and 15.5%, 11.2%, 0% in patients on no DF, DF/post-HCT and DF/pre-HCT. DF may have a role in decreasing incidence and severity of aGvHD, especially if used concurrently with conditioning regimen.

摘要

有一些初步证据表明,用去纤苷(DF)预防静脉闭塞性疾病可能也有助于通过防止组织损伤来降低急性移植物抗宿主病(aGvHD)的风险。在本研究中,我们旨在探讨DF预防在D + 180时对aGvHD发生的作用。对195例连续接受异基因造血干细胞移植的成年患者进行回顾性评估,分为3组:未使用DF组、移植后使用DF组(DF于D + 1至D + 14使用)和移植前使用DF组(DF在预处理期间同时使用14天)。未使用DF组、移植后使用DF组和移植前使用DF组患者在D + 180时的aGvHD总发生率(p:0.057)和III/IV级发生率(p:0.051)分别为46.5%、40%、25.5%和15.5%、11.2%、0%。DF可能有助于降低aGvHD的发生率和严重程度,尤其是与预处理方案同时使用时。

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