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患者的年龄和 D-二聚体水平可预测 TAFRO 综合征患者的预后。

Patient's age and D-dimer levels predict the prognosis in patients with TAFRO syndrome.

机构信息

Department of Hematology and Immunology, Kanazawa Medical University, 1-1 Daigaku, Uchinada, Ishikawa-ken, 920-0293, Japan.

Department of Hematology and Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

Int J Hematol. 2021 Aug;114(2):179-188. doi: 10.1007/s12185-021-03159-x. Epub 2021 Apr 30.

Abstract

OBJECTIVES

To identify prognostic factors for TAFRO syndrome, a rare inflammatory disorder of unknown etiology characterized by thrombocytopenia, anasarca, fever, reticulin myelofibrosis, renal dysfunction, and organomegaly.

METHODS

Data of patients with TAFRO syndrome were extracted from a Japanese patient registry. Patients were divided into groups according to the clinical and laboratory parameters at initial presentation. Cut-off values for the laboratory parameters were determined using receiver operating characteristic curve analysis and by clinical relevance. Patient survival was analyzed by the Kaplan-Meier method. Univariable analysis was performed using log-rank tests. Multivariable analyses were performed with the logistic regression model and the Cox proportional hazards model.

RESULTS

We extracted the data of 83 patients with TAFRO syndrome from the registry. Univariable analysis identified several potential prognostic factors. Of these factors, age ≥60 years and D-dimer ≥18 μg/dL remained significant predictors of poor overall survival in the multivariable Cox proportional hazards model. Based on these results, we developed a simple prognostic scoring system for TAFRO syndrome (TS-PSS).

CONCLUSION

Patients in our cohort were stratified into low, intermediate, and high-risk groups by the TS-PSS. This system should be verified with independent patient cohorts in future studies.

摘要

目的

确定 TAFRO 综合征的预后因素,TAFRO 综合征是一种罕见的病因不明的炎症性疾病,其特征为血小板减少症、全身性水肿、发热、网状纤维骨髓纤维化、肾功能障碍和器官肿大。

方法

从日本患者登记处提取 TAFRO 综合征患者的数据。根据初始表现时的临床和实验室参数将患者分为不同组。使用受试者工作特征曲线分析和临床相关性确定实验室参数的截断值。使用 Kaplan-Meier 法分析患者生存情况。使用对数秩检验进行单变量分析。使用逻辑回归模型和 Cox 比例风险模型进行多变量分析。

结果

我们从登记处提取了 83 例 TAFRO 综合征患者的数据。单变量分析确定了几个潜在的预后因素。在多变量 Cox 比例风险模型中,年龄≥60 岁和 D-二聚体≥18 μg/dL 仍然是总体生存不良的显著预测因素。基于这些结果,我们开发了 TAFRO 综合征(TS-PSS)的简单预后评分系统。

结论

我们的队列中的患者通过 TS-PSS 分为低、中、高危组。该系统应在未来的研究中通过独立的患者队列进行验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc60/8085640/6a6f3fea1f0c/12185_2021_3159_Fig1_HTML.jpg

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