The Third Affiliated Hospital of Sun Yat-Sen University, China.
Transfus Apher Sci. 2020 Jun;59(3):102743. doi: 10.1016/j.transci.2020.102743. Epub 2020 Feb 28.
To analyze the impact of donor- and recipient-related factors on Graft-versus-host disease (GVHD) and overall survival of transplantation from matched sibling donors.
we retrospectively analyzed the clinical features of 68 consecutive hematological patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT) from matched sibling from 2011 and 2017.
The incidence of Ⅱ- Ⅳacute GVHD (aGVHD) and chronic GVHD (cGVHD) after transplantation was 13.6 % and 19.7 %, respectively. We also noted the donor and recipient characteristics had no impact on Ⅱ- Ⅳ aGVHD incidence.We found sex mismatch (F-M) did not increase the risk of cGVHD in the model if a female donor was younger than 30 years (P = 1.000), but cGVHD increased if the female donor was ≥30 years (P = 0.002). Recipients≥40 years undergoing HCT from donors ≥30 years were at higher risk for cGVHD (P = 0.021). Development of Ⅱ- Ⅳ aGVHD and cGVHD had no effect on overall survival (P = 0.159, 0.081). Non-remission status at allo-HCT was linked to lower overall survival (P = 0.001).
The incidence of cGVHD was higher when male recipients received hematopoietic progenitor cells from female ≥30 years donors, and when older than 40 years recipients received hematopoietic progenitor cells from ≥30 years donors. Patients in non-remission status at allo-HCT was inclined to have lower overall survival.
分析供者和受者相关因素对同胞供者异基因造血干细胞移植(allo-HSCT)后移植物抗宿主病(GVHD)和总生存的影响。
我们回顾性分析了 2011 年至 2017 年 68 例连续接受同胞供者 allo-HSCT 的血液系统疾病患者的临床特征。
移植后Ⅱ-Ⅳ级急性移植物抗宿主病(aGVHD)和慢性移植物抗宿主病(cGVHD)的发生率分别为 13.6%和 19.7%。我们还注意到供者和受者特征对Ⅱ-Ⅳ级 aGVHD 发生率没有影响。我们发现,如果女性供者年龄<30 岁,性别不匹配(F-M)不会增加 cGVHD 的风险(P=1.000),但如果女性供者年龄≥30 岁,cGVHD 会增加(P=0.002)。受者年龄≥40 岁,供者年龄≥30 岁,cGVHD 风险较高(P=0.021)。Ⅱ-Ⅳ级 aGVHD 和 cGVHD 的发生对总生存无影响(P=0.159,0.081)。allo-HSCT 时未缓解状态与总生存较低相关(P=0.001)。
当男性受者接受来自年龄≥30 岁的女性供者的造血祖细胞时,以及当年龄>40 岁的受者接受来自年龄≥30 岁的供者的造血祖细胞时,cGVHD 的发生率较高。allo-HSCT 时未缓解状态的患者总生存倾向较低。