Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-Town, Kita-County, Kagawa, 761-0793, Japan.
Department of Hematology, Takamatsu Red Cross Hospital, Takamatsu, Kagawa, Japan.
Sci Rep. 2023 Aug 10;13(1):13005. doi: 10.1038/s41598-023-39604-6.
Ascites is sometimes detected after allogeneic hematopoietic stem cell transplantation (allo-HSCT); however, since limited information is currently available, its clinical meaning remains unclear. Therefore, we herein examined potential factors for and the impact of ascites on the prognosis of patients after allo-HSCT at our institutes. Fifty-eight patients developed ascites within 90 days of allo-HSCT (small in 34 (16%), moderate-large in 24 (11%)). A multivariate analysis identified veno-occlusive disease/sinusoidal obstruction syndrome (p = 0.01) and myeloablative conditioning (p = 0.01) as significant potential factors for the development of small ascites. Thrombotic microangiopathy (TMA) (p < 0.01) was a significant potential factor for moderate-large ascites. The incidence of both small and moderate-large ascites correlated with lower overall survival (p = 0.03 for small ascites and p < 0.01 for moderate-large ascites) and higher non-relapse mortality rates (p = 0.03 for small ascites and p < 0.01 for moderate-large ascites). Lower OS and higher NRM rates correlated with the incidence of both small and moderate-large ascites. Further investigation is warranted to establish whether the clinical sign of ascites improves the diagnostic quality of TMA in a large-scale study.
在异基因造血干细胞移植（allo-HSCT）后有时会检测到腹水；然而，由于目前信息有限，其临床意义尚不清楚。因此，我们在此检查了腹水发生的潜在因素及其对我院 allo-HSCT 后患者预后的影响。58 例患者在 allo-HSCT 后 90 天内出现腹水（小量 34 例（16%），中大量 24 例（11%））。多变量分析确定静脉闭塞病/窦状隙阻塞综合征（VOD/SOS）（p=0.01）和清髓性预处理（p=0.01）是小量腹水发生的显著潜在因素。血栓性微血管病（TMA）（p<0.01）是中大量腹水发生的显著潜在因素。小量和中大量腹水的发生率均与总生存率降低相关（小量腹水 p=0.03，中大量腹水 p<0.01）和非复发死亡率升高相关（小量腹水 p=0.03，中大量腹水 p<0.01）。较低的 OS 和较高的 NRM 率与小量和中大量腹水的发生率相关。需要进一步研究以确定腹水的临床征象是否能在大规模研究中提高 TMA 的诊断质量。
