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造血干细胞移植受者手足综合征的发生及其危险因素。

Hand-foot syndrome and risk factors for occurrence in hematopoietic stem cell transplantation recipients.

机构信息

Department of Healthcare and Regulatory Sciences, Showa University School of Pharmacy, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.

Department of Pharmacy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.

出版信息

Support Care Cancer. 2022 Feb;30(2):1539-1546. doi: 10.1007/s00520-021-06573-3. Epub 2021 Sep 18.

DOI:10.1007/s00520-021-06573-3
PMID:34536133
Abstract

PURPOSE

Hand-foot syndrome (HFS) is a typical skin disorder caused by the use of cytotoxic anticancer drugs and molecular targets. Similarly, various anticancer drugs have been used as a conditioning regimen for hematopoietic stem cell transplantation (HSCT), and skin disorders such as HFS have been reported. The aim of this study was to determine retrospectively the frequency of HFS in recipients who have received a first allogeneic HSCT and the risk factors for HFS occurrence.

METHODS

We retrospectively investigated the medical records of recipients who received their first allogeneic HSCT and neutrophil engraftment at Shizuoka Cancer Center from January 1, 2011, to December 31, 2019.

RESULTS

The occurrence of HFS was confirmed in 78 cases (48.1%), and no grade 3 HFS was confirmed. The median occurrence of HFS was 8 (- 3 to 19) days. In recipients with and without confirmed HFS, the median neutrophil engraftment day was 16.5 (10-33) and 15.0 (11-26) days, respectively (p = 0.013). Multivariate analysis indicated that the frequency of HFS was statistically significantly higher in women (p = 0.032), recipients administered busulfan (Bu) four times daily (p = 0.011), and recipients previously treated with anthracycline (p = 0.002).

CONCLUSION

Attention should be paid to HFS that occurs due to the conditioning regimen for HSCT in women, recipients who received 0.8 mg/kg of Bu four times a day, and recipients with a history of anthracycline administration, as HFS may affect the duration to neutrophil engraftment.

摘要

目的

手足综合征(HFS)是一种由细胞毒性抗癌药物和分子靶标引起的典型皮肤疾病。同样,各种抗癌药物已被用作造血干细胞移植(HSCT)的预处理方案,并且已报告出现 HFS 等皮肤疾病。本研究的目的是回顾性确定接受首次异基因 HSCT 且中性粒细胞植入的受者中 HFS 的频率以及 HFS 发生的危险因素。

方法

我们回顾性调查了 2011 年 1 月 1 日至 2019 年 12 月 31 日在静冈癌症中心接受首次异基因 HSCT 和中性粒细胞植入的受者的病历。

结果

确认发生了 78 例(48.1%)HFS,未确认 3 级 HFS。HFS 的中位发生时间为 8(-3 至 19)天。在确认有和没有 HFS 的受者中,中性粒细胞植入的中位时间分别为 16.5(10-33)和 15.0(11-26)天(p=0.013)。多变量分析表明,女性(p=0.032)、每日四次接受白消安(Bu)的受者(p=0.011)和既往接受蒽环类药物治疗的受者(p=0.002)中 HFS 的发生频率统计学上显著更高。

结论

对于 HSCT 预处理方案引起的 HFS、接受 0.8mg/kg Bu 每日四次的受者以及有蒽环类药物治疗史的受者,应注意 HFS,因为 HFS 可能会影响中性粒细胞植入的时间。

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