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同种异体造血干细胞移植治疗低增生性骨髓增生异常综合征的结果。

Outcome of allogeneic hematopoietic stem cell transplantation for hypoplastic myelodysplastic syndrome.

机构信息

Department of Hematology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1 Panfu Road, Guangzhou, 510180, Guangdong, People's Republic of China.

出版信息

Int J Hematol. 2020 Dec;112(6):825-834. doi: 10.1007/s12185-020-02969-9. Epub 2020 Aug 16.

Abstract

The prognosis of patients with hypoplastic myelodysplastic syndrome (hMDS) after receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains unclear. This study aimed to evaluate the outcomes of patients with hMDS after allo-HSCT. Between September 2013 and October 2019, a total of 20 consecutive patients with hMDS and 1 patient with clonal cytopenia of undermined significance (CCUS) who underwent allo-HSCT, which included procedures with 9 matched sibling donors, 2 matched unrelated donors, 4 mismatched unrelated donors and 6 haploidentical donors, were enrolled in this study. The median time for myeloid engraftment was 11 days (range 9-17 days), and that for platelet engraftment was 10 days (range 7-17 days). The cumulative incidence (CI) of myeloid and platelet recovery was 95.2 ± 6.0% and 90.5 ± 7.3%, respectively. The CI rates were 40.0 ± 11.3% for grades II-III acute graft-versus-host disease (GVHD), 36.8 ± 11.5% for chronic GVHD and 23.8 ± 9.6% for nonrelapse mortality. No patients experienced relapse. Sixteen surviving patients were followed up for a median of 1113 days (range 110-2305 days), and the overall survival and relapse-free survival rates were both 72.7 ± 10.6%. This limited retrospective analysis suggests that patients with hMDS had a favorable survival after allo-HSCT.

摘要

低增生性骨髓增生异常综合征(hMDS)患者接受异基因造血干细胞移植(allo-HSCT)后的预后仍不清楚。本研究旨在评估 hMDS 患者接受 allo-HSCT 后的结局。

2013 年 9 月至 2019 年 10 月,共纳入 20 例连续接受 allo-HSCT 的 hMDS 患者和 1 例克隆性细胞减少伴意义未明(CCUS)患者。其中,9 例接受同胞供者移植,2 例接受无关供者移植,4 例接受非血缘供者移植,6 例接受单倍体相合供者移植。

中性粒细胞植入的中位时间为 11 天(9-17 天),血小板植入的中位时间为 10 天(7-17 天)。

髓系和血小板恢复的累积发生率(CI)分别为 95.2±6.0%和 90.5±7.3%。Ⅱ-Ⅲ级急性移植物抗宿主病(GVHD)、慢性 GVHD 和非复发死亡率的 CI 率分别为 40.0±11.3%、36.8±11.5%和 23.8±9.6%。无患者复发。16 例存活患者中位随访 1113 天(110-2305 天),总生存率和无复发生存率均为 72.7±10.6%。

这项有限的回顾性分析表明,hMDS 患者在 allo-HSCT 后有较好的生存。

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