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亲缘单倍体造血干细胞移植后儿童身体和情绪功能显著改善。

Significant improvement of child physical and emotional functioning after familial haploidentical stem cell transplant.

机构信息

Department of Medicine and Pediatrics, Tufts Medical Center, Boston, MA, USA.

Department of Pediatrics, New York Medical College, Valhalla, NY, USA.

出版信息

Bone Marrow Transplant. 2022 Apr;57(4):586-592. doi: 10.1038/s41409-022-01584-y. Epub 2022 Feb 2.

DOI:10.1038/s41409-022-01584-y
PMID:35110690
Abstract

Allogeneic stem cell transplantation (AlloSCT) represents the only curative therapy for sickle cell disease (SCD). However, limited availability of matched related donors and suboptimal outcomes following AlloSCT with unrelated donors has led to investigation of alternative donors. Among children with high-risk SCD, we evaluated health-related quality of life (HRQoL) impact in the two years following familial haploidentical SCT. HRQoL was collected from parent and child raters, using the Child Health Ratings Inventories Generic measure and haploidentical SCT-specific module. Repeated measures models were fit to assess HRQoL changes over time and by rater. Nineteen children (mean age 12.9 yrs [standard deviation, 5.3]; 63% male) and their parents were included. There were no differences in the 2-yr trajectories of child physical or emotional functioning (EF) by rater. Child physical functioning and EF scores were significantly lower at day +45 than baseline, but scores recovered by day +180. There was significant improvement in EF (p = 0.03) at 2 yrs vs baseline. A similar pattern of scores over time was seen for parent ratings of child's global HRQoL. Despite treatment intensity in the initial months following AlloSCT, patient scores recovered or exceeded baseline scores at two years. This trial is registered at clinicaltrials.gov (NCT01461837).

摘要

异基因干细胞移植(AlloSCT)是治疗镰状细胞病(SCD)的唯一根治性疗法。然而,由于匹配相关供体的可用性有限,以及非相关供体 AlloSCT 的结果不理想,因此已经开始探索替代供体。在患有高危 SCD 的儿童中,我们评估了亲缘单倍体相合 SCT 后两年内与健康相关的生活质量(HRQoL)的影响。使用儿童健康评分量表通用量表和单倍体相合 SCT 特定模块,从父母和儿童评估者那里收集 HRQoL。拟合重复测量模型来评估 HRQoL 随时间和评估者的变化。纳入了 19 名儿童(平均年龄 12.9 岁[标准差,5.3];63%为男性)及其父母。评估者评估的儿童生理或情感功能(EF)在 2 年内没有差异。与基线相比,第 45 天儿童的生理功能和 EF 评分明显较低,但在第 180 天恢复。与基线相比,EF 在 2 年时显著改善(p=0.03)。父母对孩子总体 HRQoL 的评分也呈现出相似的时间模式。尽管在 AlloSCT 后最初几个月的治疗强度很大,但患者的评分在两年内恢复或超过基线。该试验在 clinicaltrials.gov 注册(NCT01461837)。

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本文引用的文献

1
Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation.健康相关生活质量变化的解读:半个标准差的显著普遍性。
Med Care. 2003 May;41(5):582-92. doi: 10.1097/01.MLR.0000062554.74615.4C.
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Availability of related donors for bone marrow transplantation in sickle cell anemia.镰状细胞贫血患者进行骨髓移植时相关供体的可获得性。
Am J Pediatr Hematol Oncol. 1994 Feb;16(1):27-9.
Excellent outcome of stem cell transplantation for sickle cell disease.
镰状细胞病干细胞移植的出色疗效
Ann Hematol. 2023 Nov;102(11):3217-3227. doi: 10.1007/s00277-023-05447-4. Epub 2023 Sep 19.