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异基因造血细胞移植后 20 年成人幸存者的合并症谱。

Comorbidity profile of adult survivors at 20 years following allogeneic hematopoietic cell transplantation.

机构信息

Hans Messner Allogeneic Transplant Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.

出版信息

Eur J Haematol. 2021 Feb;106(2):241-249. doi: 10.1111/ejh.13542. Epub 2020 Nov 17.

Abstract

UNLABELLED

Numerous chronic medical conditions and complications can arise following allogeneic hematopoietic cell transplantation (HCT) that may have a negative impact on survival and quality of life.

OBJECTIVE

The purpose of the present study was to review the comorbidities of a single-center cohort of allogeneic HCT recipients that survived 20 years postallogeneic transplantation.

METHODS

We retrospectively investigated 172 patients that underwent allogeneic HCT at the Princess Margaret Cancer Centre between 1979 and 1998 and who survived at least 20 years post-HCT.

RESULTS

The most frequent individual comorbidities documented were dyslipidemia (29%), hypertension (31%), osteoporosis (15%), hypothyroidism (15%), and depression/anxiety (13%). Follow-up data following the 20-year mark were available for 135 patients, overall survival (OS) of that group at 5 and 10 years was 94% and 90%, respectively. When grouped by the number of concurrent comorbidities, there was a significant difference in OS between the groups with 0-1, 2-3, and ≥4 comorbidities (P = .01).

CONCLUSIONS

Evidently, long-term allogeneic HCT recipients may develop a number of comorbidities that negatively influence survival even past the 20-year post-transplant mark. These findings warrant the continuous long-term medical follow-up of allogeneic transplant patients, regardless of age or time that has lapsed post-HCT.

摘要

未注明

异体造血细胞移植(HCT)后会出现许多慢性医学疾病和并发症,这可能对生存和生活质量产生负面影响。

目的

本研究的目的是回顾单中心异体 HCT 受者 20 年后的合并症。

方法

我们回顾性调查了 1979 年至 1998 年在玛格丽特公主癌症中心接受异体 HCT 且至少 20 年后存活的 172 名患者。

结果

记录的最常见的个体合并症为血脂异常(29%)、高血压(31%)、骨质疏松症(15%)、甲状腺功能减退症(15%)和抑郁/焦虑(13%)。135 名患者在 20 年标记后可获得随访数据,该组的 5 年和 10 年总生存率(OS)分别为 94%和 90%。按并发合并症数量分组时,0-1、2-3 和≥4 种合并症组的 OS 存在显著差异(P=.01)。

结论

显然,长期异体 HCT 受者可能会出现许多合并症,即使在移植后 20 年仍会对生存产生负面影响。这些发现证明无论年龄或移植后时间如何,都需要对异体移植患者进行持续的长期医学随访。

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