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使用移植评估量表进行心理社会移植前筛查有助于预测造血干细胞移植后的生存率。

Psychosocial Pre-Transplant Screening With the Transplant Evaluation Rating Scale Contributes to Prediction of Survival After Hematopoietic Stem Cell Transplantation.

作者信息

Scherer Simon, Scheid Christoph, von Bergwelt Michael, Hellmich Martin, Albus Christian, Vitinius Frank

机构信息

Department of Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.

Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital, University Hospital Tuebingen, Tuebingen, Germany.

出版信息

Front Psychiatry. 2021 Oct 8;12:741438. doi: 10.3389/fpsyt.2021.741438. eCollection 2021.

Abstract

There is no standard in hematopoietic stem cell transplantations (HSCT) for pre-transplant screening of psychosocial risk factors, e.g., regarding immunosuppressant non-adherence. The aim of this prospective study is to explore the predictive value of the pretransplant psychosocial screening instrument Transplant Evaluation Rating Scale (TERS) for mortality in a 3-year follow-up. Between 2012 and 2017 61 patients were included and classified as low (TERS = 26.5-29) and increased-risk group (TERS = 29.5-79.5). Both groups were compared regarding mortality until 36 months after transplantation and secondary outcomes [Medication Experience Scale for Immunosuppressants (MESI); incidence/grade of GvHD]. The increased-risk group ( = 28) showed significantly worse cumulative survival in the outpatient setting (from 3 months to 3 years after HSCT) [Log Rank (Mantel Cox) = 0.029] compared to low-risk group ( = 29) but there was no significant result for the interval immediately after HSCT until 3 years afterwards. Pre-transplant screening with TERS contributes to prediction of survival after HSCT. The reason remains unclear, since TERS did not correlate with GvHD or MESI. The negative result regarding the interval immediately after HSCT until 3 years could be caused by the intensive in-patient setting with mortality which is explained rather by biological reasons than by non-adherence.

摘要

在造血干细胞移植(HSCT)中,对于移植前心理社会风险因素的筛查,例如免疫抑制剂不依从方面,没有标准。这项前瞻性研究的目的是探讨移植前心理社会筛查工具移植评估量表(TERS)对3年随访期死亡率的预测价值。在2012年至2017年期间,纳入了61例患者,并将其分为低风险组(TERS = 26.5 - 29)和高风险组(TERS = 29.5 - 79.5)。比较了两组在移植后36个月内的死亡率以及次要结局[免疫抑制剂用药体验量表(MESI);移植物抗宿主病(GvHD)的发生率/分级]。高风险组(n = 28)在门诊环境中(HSCT后3个月至3年)的累积生存率明显低于低风险组(n = 29)[对数秩(Mantel Cox)P = 0.029],但在HSCT后即刻至3年期间没有显著差异。用TERS进行移植前筛查有助于预测HSCT后的生存率。原因尚不清楚,因为TERS与GvHD或MESI均无相关性。HSCT后即刻至3年期间的阴性结果可能是由于住院期间死亡率较高,其原因更多是生物学因素而非不依从。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbd8/8533822/61df308ff7b1/fpsyt-12-741438-g0001.jpg

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