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在三级保健中心接受治疗的患有骨髓衰竭疾病的儿科患者的结局。

Outcomes in pediatrics patients diagnosed with bone marrow failure disorders treated in a tertiary care center.

机构信息

Servicio de Hemato-Oncología Pediátrica y Trasplante de Médula Ósea, Fundación Valle del Lili, Cali, Colombia.

Centro de Investigaciones Clínicas, Fundación Valle del Lili, Cali, Colombia.

出版信息

Rev Chil Pediatr. 2020 Aug;91(4):545-552. doi: 10.32641/rchped.vi91i4.1579. Epub 2020 Sep 11.

Abstract

INTRODUCTION

Bone marrow failure (BMF) syndromes are rare disorders with an annual incidence of 2-4 cases per million. Treatment options include immunosuppressive therapy (IST) and hematopoietic stem cell transplantation (HSCT).

OBJECTIVE

To analyze the outcomes of pediatric patients diagnosed with BMF treated in a tertiary care center.

PATIENTS AND METHOD

Retrospective study of pediatric patients diagnosed with BMF who consulted at Fundación Valle de Lili, Cali. Descriptive statistical analysis was performed according to Acquired BMF (ABMF) and Inherited BMF (IBMF). The outcomes include treatment, complications, overall survival (OS) in transplant patients, calculated using the Kaplan Meier method.

RESULTS

We included 24 patients with BMF, average age 6.5 ± 4 years, and 50% were women. 58% presented IBMF, 9 with Fanconi anemia (FA), 2 dyskeratosis congenita, 2 congenital amegakaryocytic thrombocytopenia, and 1 presented Diamond-Blackfan anemia. 12 patients treated with HSCT had a 5-year OS of 83%. ABMF represented 42%. 6 patients received IST-HSCT, 3 received IST, and 1 received HSCT. The OS of the IST-HSCT group was 86%. Six patients died, four of them related to infection.

CONCLUSIONS

In this series, there was a higher number of cases with IBMF. The OS of patients treated with HSCT is similar to that reported in recent studies. The most frequent cause of death was of infectious origin which has also been previously reported. The treatment esta blished in the patients showed favorable results in a Latin American tertiary care center.

摘要

简介

骨髓衰竭(BMF)综合征是一种罕见疾病,年发病率为每百万人口 2-4 例。治疗选择包括免疫抑制疗法(IST)和造血干细胞移植(HSCT)。

目的

分析在三级护理中心接受治疗的儿童骨髓衰竭患者的结局。

患者和方法

回顾性分析在卡利的 Fundacion Valle de Lili 就诊的被诊断为 BMF 的儿科患者。根据获得性 BMF(ABMF)和遗传性 BMF(IBMF)进行描述性统计分析。结果包括治疗、并发症、移植患者的总生存率(OS),使用 Kaplan-Meier 方法计算。

结果

我们纳入了 24 例 BMF 患者,平均年龄为 6.5 ± 4 岁,50%为女性。58%的患者存在 IBMF,9 例为范可尼贫血(FA),2 例为先天性角化不良,2 例为先天性巨核细胞血小板减少症,1 例为 Diamond-Blackfan 贫血。12 例接受 HSCT 的患者 5 年 OS 为 83%。ABMF 占 42%。6 例接受 IST-HSCT,3 例接受 IST,1 例接受 HSCT。IST-HSCT 组的 OS 为 86%。6 例患者死亡,其中 4 例与感染有关。

结论

在本系列中,存在更多的 IBMF 病例。接受 HSCT 治疗的患者的 OS 与最近的研究报告相似。死亡的最常见原因是感染,这也在之前的研究中报告过。在拉丁美洲的三级护理中心,患者所接受的治疗方案显示出良好的效果。

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