Zhang Lin-Yi, Xiong Yi-Ying, Liao Ming-Yan, Xiao Qing, Tang Xiao-Qiong, Luo Xiao-Hua, Zhang Hong-Bin, Wang Li, Liu Lin
Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Dec;32(6):1875-1881. doi: 10.19746/j.cnki.issn.1009-2137.2024.06.037.
To analyze the risk factors of primary poor graft function (PGF) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myeloid malignancies and the impact of primary PGF on survival.
The clinical data of 146 patients with myeloid malignancies who underwent allo-HSCT in our hospital from January 2015 to December 2021 were retrospectively studied. Some relevant clinical parameters which may affect the development of primary PGF after allo-HSCT were selected for univariate and multivariate analysis, as well as performed survival analysis.
A total of 9 patients (6.16%) were diagnosed with primary PGF, and their medium age was 37(28-53) years old. Among them, 1 case underwent matched sibling donor HSCT, 1 case underwent matched unrelated donor HSCT, and 7 cases underwent HLA-haploidentical related donor HSCT. Moreover, 5 cases were diagnosed as cytomegalovirus (CMV) infection, and 3 cases as Epstein-Barr virus (EBV) infection. Univariate and multivariate analysis showed that CD34 cell dose <5×10/kg and pre-transplant C-reactive protein (CRP) >10 mg/L were independent risk factors for occurrence of the primary PGF after allo-HSCT in patients with myeloid malignancies. The 3-year overall survival (OS) rate of primary PGF group was 52.5%, which was significantly lower than 82.8% of good graft function group ( < 0.05).
Making sure pre-transplant CRP≤10 mg/L and CD34 cell dose ≥5×10/kg in the graft may have an effect on preventing the occurrence of primary PGF after allo-HSCT. The occurrence of primary PGF may affect the OS rate of transplant patients, and early prevention and treatment are required.
分析髓系恶性肿瘤患者异基因造血干细胞移植（allo-HSCT）后原发性移植物功能不良（PGF）的危险因素及原发性PGF对生存的影响。
回顾性研究2015年1月至2021年12月在我院接受allo-HSCT的146例髓系恶性肿瘤患者的临床资料。选择一些可能影响allo-HSCT后原发性PGF发生的相关临床参数进行单因素和多因素分析，并进行生存分析。
共有9例患者（6.16%）被诊断为原发性PGF，中位年龄为37（28-53）岁。其中，1例接受了同胞全相合供者HSCT，1例接受了非血缘全相合供者HSCT，7例接受了HLA单倍体相合相关供者HSCT。此外，5例被诊断为巨细胞病毒（CMV）感染，3例为EB病毒（EBV）感染。单因素和多因素分析显示，CD34细胞剂量<5×10⁶/kg和移植前C反应蛋白（CRP）>10 mg/L是髓系恶性肿瘤患者allo-HSCT后发生原发性PGF的独立危险因素。原发性PGF组的3年总生存（OS）率为52.5%，显著低于移植功能良好组的82.8%（P<0.05）。
确保移植前CRP≤10 mg/L且移植物中CD34细胞剂量≥5×10⁶/kg可能对预防allo-HSCT后原发性PGF的发生有作用。原发性PGF的发生可能影响移植患者的OS率，需要早期预防和治疗。
