Yang Huan, Li Zhi-Tao, Lin Ren, Fan Zhi-Ping, Huang Fen, Jiang Qian-Li, Zhou Hong-Sheng, Liu Qi-Fa, Sun Jing
Department of Hematology, Institute of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. E-mail:
Nan Fang Yi Ke Da Xue Xue Bao. 2016 Jun;36(6):807-13.
To investigate the incidence and risk factors of sclerodermatous chronic graft-versus-host disease (ScGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).
The clinical data of 259 patients undergoing allo-HSCT in Nanfang Hospital between January, 2012 and December, 2014 were analyzed.
Chronic GVHD following allo-HSCT occurred in 134 (51.7%) cases, among whom 22 patients showed sclerodermatous features at a median of 12.5 months (range 4-28 months) after the transplantation. The overall incidence of ScGVHD was 8.49% (22/259) in the recipients and 16.4% (22/134) in those with cGVHD. Univariate analysis showed that the conditioning regimen with total body irradiation (P=0.031), GVHD prophylaxis with MMF (P=0.046), presence of chronic GVHD (P=0.008), and donor lymphocyte infusion (P=0.001) were all closely associated with the occurrence of ScGVHD. Multivariate analysis identified chronic GVHD (RR=3.512, 95%CI: 1.235-9.987, P=0.018) and donor lymphocyte infusion (RR=5.217, 95%CI: 1.698-16.029, P=0.004) as the independent risk factors of ScGVHD.
ScGVHD following allo-HSCT is not a common complication, and cGVHD and donor lymphocyte infusion are the independent risk factors for ScGVHD.
探讨异基因造血干细胞移植(allo-HSCT)后硬皮病样慢性移植物抗宿主病(ScGVHD)的发生率及危险因素。
分析2012年1月至2014年12月在南方医院接受allo-HSCT的259例患者的临床资料。
allo-HSCT后发生慢性移植物抗宿主病(cGVHD)134例(51.7%),其中22例在移植后中位时间12.5个月(4-28个月)出现硬皮病样表现。ScGVHD在受者中的总发生率为8.49%(22/259),在cGVHD患者中为16.4%(22/134)。单因素分析显示,全身照射预处理方案(P=0.031)、霉酚酸酯预防移植物抗宿主病(P=0.046)、存在慢性移植物抗宿主病(P=0.008)和供者淋巴细胞输注(P=0.001)均与ScGVHD的发生密切相关。多因素分析确定慢性移植物抗宿主病(RR=3.512,95%CI:1.235-9.987,P=0.018)和供者淋巴细胞输注(RR=5.217,95%CI:1.698-16.029,P=0.004)为ScGVHD的独立危险因素。
allo-HSCT后ScGVHD并非常见并发症,cGVHD和供者淋巴细胞输注是ScGVHD的独立危险因素。