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造血干细胞移植后继发白癜风:来自韩国的全国基于人群的队列研究。

Subsequent vitiligo after hematopoietic stem cell transplantation: A nationwide population-based cohort study from Korea.

机构信息

Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Department of Dermatology, Veterans Health Service Medical Center, Seoul, Korea.

出版信息

J Am Acad Dermatol. 2017 Mar;76(3):459-463. doi: 10.1016/j.jaad.2016.08.064. Epub 2016 Nov 8.

Abstract

BACKGROUND

Subsequent vitiligo after hematopoietic stem cell transplantation (HSCT) has been described sporadically in case series.

OBJECTIVE

To investigate the incidence and risk factors of subsequent vitiligo after HSCT.

METHODS

A nationwide, population-based cohort study was performed using the Korean National Health Insurance Claims Database from 2009 to 2013. All HSCT recipients who had undergone HSCT between 2010 and 2011 and not treatment for vitiligo in 2009 (to exclude preexisting active vitiligo) were included in the HSCT recipient group, and an age- and sex-matched control group without HSCT was also established.

RESULTS

A total of 2747 HSCT recipients and 8241 controls were enrolled. Newly acquired vitiligo occurred in 1.06% of HSCT recipients between 2010 and 2013, and there was a significant increase (OR 3.130, 95% CI 1.859-5.271) in cases of vitiligo in HSCT recipients compared with controls (0.34%). Allogeneic HSCT (OR 5.593, 95% CI 1.628-19.213) and bone marrow-sourced stem cells (as compared with peripheral blood-sourced stem cells; OR 2.492, 95% CI 1.114-5.576) were independently associated with the development of vitiligo after HSCT.

LIMITATIONS

Medical record review was not available.

CONCLUSION

Vitiligo developed at a significantly increased rate after HSCT compared with controls. Allogeneic HSCT and bone marrow-sourced stem cells were independent risk factors.

摘要

背景

造血干细胞移植(HSCT)后继发白癜风的病例偶有报道。

目的

探讨 HSCT 后继发白癜风的发生率及相关危险因素。

方法

本研究采用 2009 年至 2013 年韩国国家健康保险数据库进行全国性基于人群的队列研究。纳入 2010 年至 2011 年期间接受 HSCT 且 2009 年无白癜风治疗史(以排除预先存在的活动性白癜风)的所有 HSCT 受者,并设立年龄和性别匹配的无 HSCT 对照组。

结果

共纳入 2747 例 HSCT 受者和 8241 例对照者。2010 年至 2013 年期间,HSCT 受者中有 1.06%新发白癜风,HSCT 受者白癜风的发生率显著高于对照组(3.130,95%CI 1.859-5.271)。与对照组相比,异基因 HSCT(OR 5.593,95%CI 1.628-19.213)和骨髓来源的干细胞(与外周血来源的干细胞相比;OR 2.492,95%CI 1.114-5.576)与 HSCT 后白癜风的发生独立相关。

局限性

本研究未进行病历回顾。

结论

与对照组相比,HSCT 后白癜风的发生率显著升高。异基因 HSCT 和骨髓来源的干细胞是独立的危险因素。

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