Division of Hematology, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho Omiya-ku, Saitama, 330-8503, Japan.
Ann Hematol. 2020 Jun;99(6):1369-1376. doi: 10.1007/s00277-020-03990-y. Epub 2020 Mar 16.
Allogeneic hematopoietic transplantation (allo-HCT) is still associated with significant morbidity and mortality, and risk stratification is critical. In this study, we analyzed the relationship between blood pressure control early after allo-HCT and survival outcomes. All patients who survived longer than 28 days after allo-HCT at our center between June 2007 and June 2018 (n = 353) were included, and the average systolic blood pressure (asBP) from 1 to 28 days after allo-HCT was calculated. According to the results of a ROC curve analysis, an asBP of 131 mmHg was defined as a cut-off value between high and low asBP groups. Non-relapse mortality (NRM) and OS were significantly inferior in the high asBP group (2-year-NRM 28.0% vs 11.1%, P < 0.001; 2-year-OS 46.7% vs 65.7%, P = 0.001). In addition, baseline asBP before commencement of the conditioning regimen and elevation of asBP (asBP - baseline asBP) were both associated with inferior NRM. While these results were also observed in the younger patients (≤ 50 years), no relationship was observed in the older patients (> 50 years). High blood pressure within 28 days after allo-HCT was associated with inferior survival outcomes, especially in patients younger than 50 years.
异基因造血干细胞移植(allo-HCT)仍然与显著的发病率和死亡率相关,因此风险分层至关重要。在这项研究中,我们分析了 allo-HCT 后早期血压控制与生存结果之间的关系。我们纳入了中心在 2007 年 6 月至 2018 年 6 月期间存活时间超过 allo-HCT 后 28 天的所有患者(n=353),并计算了 allo-HCT 后 1 至 28 天的平均收缩压(asBP)。根据 ROC 曲线分析的结果,将 131mmHg 的 asBP 定义为高和低 asBP 组之间的分界值。高 asBP 组的非复发死亡率(NRM)和总生存率(OS)显著更差(2 年-NRM:28.0% vs 11.1%,P<0.001;2 年-OS:46.7% vs 65.7%,P=0.001)。此外,起始预处理方案前的基线 asBP 和 asBP 升高(asBP-基线 asBP)均与 NRM 不良相关。尽管这些结果在年龄较小的患者(≤50 岁)中也观察到,但在年龄较大的患者(>50 岁)中未观察到这种关系。allo-HCT 后 28 天内的高血压与生存结果不良相关,尤其是在年龄小于 50 岁的患者中。