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血液系统疾病中的异基因干细胞移植:十年经验

Allogeneic Stem Cell Transplant in Hematological Disorders: A Decade of Experience.

作者信息

Arif Salman, Ali Natasha, Shaikh Usman, Adil Salman, Jehanzeb Hamzah

机构信息

Department of Oncology, Aga Khan University Hospital, Karachi, Pakistan.

Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan.

出版信息

Int J Hematol Oncol Stem Cell Res. 2024 Oct 1;18(4):344-357. doi: 10.18502/ijhoscr.v18i4.16759.

Abstract

: Allogeneic hematopoietic cell transplantation (allo-HCT) is a complex procedure with the potential to provide curative treatment for various hematological disorders. This study aims to evaluate the outcomes of allo-HCT in hematological diseases and identify significant complications in a single-center setting. : We conducted a retrospective analysis of 180 patients with hematological diseases who underwent allo-HCT between January 2011 and December 2021. Key outcomes, including indications for transplantation, overall survival, engraftment time, relapse rates, graft-versus-host disease (GVHD), and transplant-related mortality (TRM) were assessed. : The most common indications for allo-HCT were benign hematological diseases, particularly aplastic anemia, and thalassemia major. Despite the majority of patients receiving fully matched transplants, acute GVHD was observed in 30% of the cohort. Graft failure occurred in 13 patients, with primary and secondary graft failure rates of 1.6% and 5.5%, respectively. Sepsis emerged as the primary cause of non-relapsed mortality at day 100 and beyond. The overall survival rate in this study was 62%, with 79% of patients disease-free on their last visit. : This study provides valuable insights into the treatment strategies and patient care of allo-HCT for hematological disorders by offering a comprehensive overview of multiple relevant outcomes. The findings underscore the significance of addressing complications and risk factors associated with allogeneic transplantation, including GVHD and infections. Future research should focus on further optimizing transplantation techniques to minimize complications and enhance patient survival.

摘要

异基因造血细胞移植(allo-HCT)是一种复杂的治疗手段,有可能为各种血液系统疾病提供治愈性治疗。本研究旨在评估血液系统疾病患者接受allo-HCT的治疗效果,并确定单中心环境下的重大并发症。

我们对2011年1月至2021年12月期间接受allo-HCT的180例血液系统疾病患者进行了回顾性分析。评估了关键结果,包括移植指征、总生存率、植入时间、复发率、移植物抗宿主病(GVHD)和移植相关死亡率(TRM)。

allo-HCT最常见的指征是良性血液系统疾病,尤其是再生障碍性贫血和重型地中海贫血。尽管大多数患者接受了完全匹配的移植,但30%的队列中观察到了急性GVHD。13例患者发生移植物失败,原发性和继发性移植物失败率分别为1.6%和5.5%。脓毒症成为100天及以后非复发死亡率的主要原因。本研究的总生存率为62%,79%的患者在最后一次随访时无疾病。

本研究通过全面概述多个相关结果,为血液系统疾病allo-HCT的治疗策略和患者护理提供了有价值的见解。研究结果强调了应对与异基因移植相关的并发症和风险因素的重要性,包括GVHD和感染。未来的研究应侧重于进一步优化移植技术,以尽量减少并发症并提高患者生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a67/11652702/79cca2726248/IJHOSCR-18-344-g001.jpg

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