造血干细胞移植的结局趋势：5000例移植及30年单中心经验
Trends in Outcome of Hematopoietic Stem Cell Transplantation: 5000 Transplantations and 30 Years of Single-Center Experience.
作者信息
Zubarovskaya Ludmila Stepanovna, Moiseev Ivan Sergeevich, Vladovskaya Maria Dmidrievna, Mikhailova Natalia Borisovna, Morozova Elena Vladislavovna, Bykova Tatyana Alexandrovna, Vlasova Yulia Yurievna, Paina Olesya Vladimirovna, Kazantsev Ilya Viktorovich, Slesarchuk Olga Alexandrovna, Smirnova Anna Gennadyevna, Osipova Anna Alekseevna, Stelmakh Liliya Vladimirovna, Polushin Alexey Yurievich, Goloshchapov Oleg Valerievich, Bogomolny Maxim Pavlovich, Estrina Maria Arkadievna, Popova Marina Olegovna, Kucher Maxim Anatolievich, Volkova Alisa Georgievna, Alyansky Alexander Leonidovich, Pevtcov Dmitrii Eduardovich, Ivanova Natalia Evgenievna, Babenko Elena Vitalievna, Mamaev Nikolai Nikolaevich, Gindina Tatiana Leonidovna, Vitrishchak Alina Alexandrovna, Chukhlovin Alexei Borisovich, Semenova Elena Vladimirovna, Bondarenko Sergei Nicolaevich, Kulagin Alexander Dmitrievich, Afanasyev Boris Vladimirovich
机构信息
RM Gorbacheva Research Institute, Pavlov University, 197022 Saint-Petersburg, Russia.
出版信息
Cancers (Basel). 2023 Sep 28;15(19):4758. doi: 10.3390/cancers15194758.
In this single-center analysis, we evaluated the trends in 5185 hematopoietic cell transplantations performed between 1990 and 2022. The study group comprised 3237 allogeneic (alloHCT) and 1948 autologous (autoHCT) hematopoietic cell transplantations. In the multivariate analysis, there was an improvement in event-free-survival (EFS) after autoHCT (HR 0.6, 95% CI 0.4-0.7, < 0.0001) due to reduced cumulative incidence of relapse in the last five years (56% in 2010-2014 vs. 38% in 2015-2022). An improvement in EFS after alloHCT over time was observed (HR 0.33, 95% CI 0.23-0.48, < 0.0001), which was due to reduced non-relapse mortality. No difference in cumulative relapse incidence was observed over the last decade for allografted patients. Survival after autoHCT improved in Hodgkin's disease (HR 0.1, 95% CI 0.1-0.3), multiple myeloma (HR 0.4, 95% CI 0.2-0.7) and solid tumors (HR 0.2, 95% CI 0.2-0.4), while after alloHCT, improvement was observed in acute myeloid leukemia (HR 0.3, 95% CI 0.1-0.5), acute lymphoblastic leukemia (HR 0.2, 95% CI 0.1-0.5), Hodgkin's disease (HR 0.1, 95% CI 0.0-0.4), non-Hodgkin's lymphomas and chronic lymphocytic leukemia (HR 0.2, 95% CI 0.0-0.6), inborn diseases (HR 0.2, 95% CI 0.2-0.4) and acquired aplastic anemia with matched related donors and matched unrelated donors (HR 0.3, 95% CI 0.2-0.8).
在这项单中心分析中，我们评估了1990年至2022年间进行的5185例造血细胞移植的趋势。研究组包括3237例异基因造血细胞移植（alloHCT）和1948例自体造血细胞移植（autoHCT）。在多变量分析中，autoHCT后的无事件生存期（EFS）有所改善（风险比[HR]为0.6，95%置信区间[CI]为0.4 - 0.7，P < 0.0001），这是由于过去五年复发的累积发生率降低（2010 - 2014年为56%，而2015 - 2022年为38%）。观察到alloHCT后EFS随时间推移有所改善（HR为0.33，95%CI为0.23 - 0.48，P < 0.0001），这是由于非复发死亡率降低。对于接受异基因移植的患者，在过去十年中未观察到累积复发发生率有差异。autoHCT后的生存率在霍奇金淋巴瘤（HR为0.1，95%CI为0.1 - 0.3）、多发性骨髓瘤（HR为0.4，95%CI为0.2 - 0.7）和实体瘤（HR为0.2，95%CI为0.2 - 0.4）中有所提高，而在alloHCT后，急性髓系白血病（HR为0.3，95%CI为0.1 - 0.5）、急性淋巴细胞白血病（HR为0.2，95%CI为0.1 - 0.5）、霍奇金淋巴瘤（HR为0.1，95%CI为0.0 - 0.4）、非霍奇金淋巴瘤和慢性淋巴细胞白血病（HR为0.2，95%CI为0.0 - 0.6）、先天性疾病（HR为0.2，95%CI为0.2 - 0.4）以及与匹配的相关供体和匹配的无关供体的获得性再生障碍性贫血（HR为0.3，95%CI为0.2 - 0.8）中有所提高。
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