Wang Sheng-Min, Park Sung-Soo, Park See Hyun, Kim Nak-Young, Kang Dong Woo, Na Hae-Ran, Bae Young-Yi, Lee Jong Wook, Han Seunghoon, Lim Hyun Kook
Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Hematology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Clin Psychopharmacol Neurosci. 2021 May 31;19(2):294-302. doi: 10.9758/cpn.2021.19.2.294.
No previous study examined impact of dementia in the outcome of allogeneic hematopoietic stem cell transplantation (HSCT). We aimed to investigate overall survival (OS) of patients with dementia after receiving HSCT.
Among 8,230 patients who underwent HSCT between 2002 and 2018, 5,533 patients younger than 50 years were first excluded. Remaining patients were divided into those who were and were not diagnosed with dementia before HSCT (dementia group: n = 31; no dementia: n = 2,666). Thereafter, among 2,666 participants without dementia, 93 patients were selected via propensity-matched score as non-dementia group. Patients were followed from the day they received HSCT to the occurrence of death or the last follow-up day (December 31, 2018), whichever came first.
With median follow-up of 621 days for dementia group and 654 days for non-dementia group, 2 year-OS of dementia group was lower than that of non-dementia group (53.3% [95% confidence interval, 95% CI, 59.0-80.2%] vs. 68.8% [95% CI, 38.0-68.2%], p = 0.076). In multivariate analysis, dementia had significant impacts on OS (hazard risk = 2.539, 95% CI, 1.166-4.771, p = 0.017).
Our results indicated that patients diagnosed with dementia before HSCT have 2.539 times higher risk of mortality after transplantation than those not having dementia. With number of elderly needing HSCT is increasing, further work to establish treatment guidelines for the management of HSCT in people with dementia is needed.
既往尚无研究探讨痴呆对异基因造血干细胞移植（HSCT）结局的影响。我们旨在调查接受HSCT的痴呆患者的总生存期（OS）。
在2002年至2018年间接受HSCT的8230例患者中，首先排除了5533例年龄小于50岁的患者。其余患者被分为HSCT前被诊断为痴呆和未被诊断为痴呆的两组（痴呆组：n = 31；无痴呆组：n = 2666）。此后，在2666例无痴呆的参与者中，通过倾向评分匹配选择93例患者作为非痴呆组。从患者接受HSCT之日起随访至死亡发生或最后随访日（2018年12月31日），以先到者为准。
痴呆组中位随访时间为621天，非痴呆组为654天，痴呆组的2年总生存率低于非痴呆组（53.3% [95%置信区间，95%CI，59.0 - 80.2%] 对 68.8% [95%CI，38.0 - 68.2%]，p = 0.076）。多因素分析中，痴呆对总生存期有显著影响（风险比 = 2.539，95%CI，1.166 - 4.771，p = 0.017）。
我们的结果表明，HSCT前被诊断为痴呆的患者移植后死亡风险比未患痴呆者高2.539倍。随着需要HSCT的老年人数量不断增加，需要进一步开展工作以制定痴呆患者HSCT管理的治疗指南。
