使用 SARS-CoV-2 阳性供者进行造血干细胞移植。
The Use of SARS-CoV-2-Positive Donors in Hematopoietic Stem Cell Transplantation.
机构信息
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China; Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
出版信息
Transplant Proc. 2023 Oct;55(8):1810-1814. doi: 10.1016/j.transproceed.2023.04.027. Epub 2023 Apr 28.
BACKGROUND
Since 2019, the SARS-CoV-2 pandemic has become a global issue due to its high fatality rate. Over time, the characteristics of the virus have evolved and led to the creation of an omicron strain with higher infectivity but a significantly decreased fatality rate. For patients in urgent need of hematopoietic stem cell transplantation (HSCT), whether the SARS-CoV-2 infection status of donors has a significant impact on HSCT recipients should be clarified.
METHODS
To estimate the transplantation risk of SARS-CoV-2-positive donors, 24 patients who underwent HSCT from December 1, 2022 to January 30, 2023 were retrospectively included. The ratio of the observation group (SARS-CoV-2-positive donors, n = 12) to the control group (SARS-CoV-2-negative donors, n = 12) was 1:1. We observed the time of hematopoietic reconstruction, donor chimerism, severe infection, acute graft vs host disease, and hepatic vein occlusion disease during hematopoietic reconstruction.
RESULTS
In the observation group, the average time of myeloid hematopoietic reconstruction was 11.58 days, and in the control group, it was 12.17 days (P = .3563 [>.05]). On average, all patients achieved a 90% donor chimerism rate of +13.58 (±4.5) days (P = .5121 [>.05]). The average percentage of patients that achieved successful hematopoietic reconstruction was 96.75% in the observation group and 96.31% in the control group (P = .7819 [>.05]). A total of 6 adverse events occurred during this study: 3 in the observation group and 3 in the control group.
CONCLUSIONS
Our preliminary results showed favorable short-term outcomes in recipients of SARS-CoV-2-positive HCST donors.
背景
自 2019 年以来，SARS-CoV-2 大流行因其高死亡率而成为全球性问题。随着时间的推移，病毒的特征发生了演变，导致产生了一种传染性更高但死亡率显著降低的奥密克戎株。对于急需造血干细胞移植（HSCT）的患者，应明确供者的 SARS-CoV-2 感染状况对 HSCT 受者是否有重大影响。
方法
为了估计 SARS-CoV-2 阳性供者的移植风险，回顾性纳入了 2022 年 12 月 1 日至 2023 年 1 月 30 日期间接受 HSCT 的 24 例患者。观察组（SARS-CoV-2 阳性供者，n=12）与对照组（SARS-CoV-2 阴性供者，n=12）的比例为 1:1。我们观察了造血重建期间的时间、供者嵌合、严重感染、急性移植物抗宿主病和肝静脉闭塞病。
结果
观察组的骨髓造血重建平均时间为 11.58 天，对照组为 12.17 天（P=.3563[>.05]）。平均而言，所有患者均在+13.58（±4.5）天达到 90%的供者嵌合率（P=.5121[>.05]）。观察组造血重建成功的患者平均百分比为 96.75%，对照组为 96.31%（P=.7819[>.05]）。本研究共发生 6 例不良事件：观察组 3 例，对照组 3 例。
结论
我们的初步结果显示，SARS-CoV-2 阳性 HSCT 供者的受者有良好的短期结果。
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