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可溶性白细胞介素-2 受体指数可预测脐血移植后的结局。

Soluble Interleukin-2 Receptor Index Predicts Outcomes After Cord Blood Transplantation.

机构信息

Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.

Third Department of Internal Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.

出版信息

Transplant Proc. 2021 Jan-Feb;53(1):379-385. doi: 10.1016/j.transproceed.2020.03.027. Epub 2020 May 7.

Abstract

BACKGROUND

Our previous study demonstrated that the soluble interleukin-2 receptor (sIL-2R) index, defined as the ratio of serum sIL-2R levels at neutrophil engraftment to that before conditioning, is a biomarker that can predict acute graft-vs-host disease (GVHD) after unrelated bone marrow transplantation. In the present study, we evaluated the significance of the sIL-2R index among patients who underwent cord blood transplantation (CBT).

METHODS

We retrospectively analyzed 31 patients who underwent single-unit CBT as their first transplantation for hematologic malignancies.

RESULTS

The median sIL-2R index was 4.2. The cumulative incidence of grade II to IV acute GVHD was not associated with the sIL-2R index. However, the cumulative incidence of relapse at 3 years after transplantation was significantly lower, with an sIL-2R index ≥ 3.7 than with an index < 3.7 (12.8% vs 50.0%; P = .04). As a result, the probability of overall survival at 3 years after transplantation was significantly higher in the former group than in the latter (79.8% vs 20.0%; P < .01). Only the dose of corticosteroid administered in the pre-engraftment period influenced the sIL-2 index.

CONCLUSION

The sIL-2R index can predict the incidence of relapse and probability of survival after CBT, possibly reflecting a graft-vs-leukemia effect.

摘要

背景

我们之前的研究表明,可溶性白细胞介素 2 受体(sIL-2R)指数,定义为中性粒细胞植入时血清 sIL-2R 水平与预处理前水平的比值,是一种可以预测异基因骨髓移植后急性移植物抗宿主病(GVHD)的生物标志物。在本研究中,我们评估了 sIL-2R 指数在接受脐带血移植(CBT)患者中的意义。

方法

我们回顾性分析了 31 例接受单份脐带血移植作为血液系统恶性肿瘤首次移植的患者。

结果

中位数 sIL-2R 指数为 4.2。Ⅱ至Ⅳ级急性 GVHD 的累积发生率与 sIL-2R 指数无关。然而,移植后 3 年的复发累积发生率明显较低,sIL-2R 指数≥3.7 的患者为 12.8%,而 sIL-2R 指数<3.7 的患者为 50.0%(P=.04)。因此,前者组移植后 3 年的总生存率明显高于后者(79.8% vs 20.0%;P<.01)。只有移植前期间皮质类固醇的剂量影响 sIL-2 指数。

结论

sIL-2R 指数可预测 CBT 后复发的发生率和生存率,可能反映了移植物抗白血病效应。

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