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供者和受者特征对 HLA 匹配同胞造血干细胞移植中移植物抗宿主病和生存的影响。

Impact of donor and recipient characteristics on graft-versus-host disease and survival in HLA-matched sibling hematopoietic stem cell transplantation.

机构信息

The Third Affiliated Hospital of Sun Yat-Sen University, China.

出版信息

Transfus Apher Sci. 2020 Jun;59(3):102743. doi: 10.1016/j.transci.2020.102743. Epub 2020 Feb 28.

Abstract

OBJECTIVE

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.

METHOD

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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