Syed Naveed, Afrooz Imrana, Mir Farooq Ahmed, Khan Azmat Ali, Abdulla Nada J M H, Hussain Shakir, Chandani Ashok Uttam, Hassan Amera, Samad Hanin Abdel, ElGhazali Gehad, Hashmi Shahrukh
Department of Hematology-Oncology, Sheikh Shakbout Medical City, Abu Dhabi, UAE.
Department of Clinical Research, Sheikh Shakbout Medical City, Abu Dhabi, UAE.
Int J Hematol Oncol Stem Cell Res. 2025 Apr 1;19(2):138-150. doi: 10.18502/ijhoscr.v19i2.18551.
: Patients from regions without stem cell transplantation (SCT) facilities often seek treatment abroad and return home for post-transplant care. Although extensive data exist on graft-versus-host disease (GVHD) and its risk factors, information on international SCT patients returning to countries that lack transplant facilities and expertise is scarce and not well documented. : We screened 149 transplant recipients and analyzed the data of 91 patients who received transplants abroad and were followed up at our center from January 2019 to December 2022. This observational study used data from electronic medical records and employed descriptive statistics, inferential tests, and relative risk calculations with forest plots to analyze the prevalence of GVDH and its key risk factors. : Of the recipients, 31.8% were residents of nine countries residing in the UAE, and 67.2% were UAE citizens. Adults comprised 48.3% of the recipients, whereas 51.7% were pediatric patients. Hematological malignancy was the most common indication (49%), primarily in adults. Siblings comprised the majority of donors (52.6%), followed by related (23.09%) and unrelated donors (8.9%). Most patients (69.2%) received HLA-identical transplants, followed by 21.9% who received haplo-identical transplants. Among adults, 62.2% developed GVHD compared to 26% of pediatric patients. Recipients from related HLA-identical donors had a 50% prevalence of GVDH, whereas those from unrelated identical donors had a 71% prevalence. The overall prevalence of GVDH was 50% in 87.9% of patients who received allogeneic SCTs. : Despite favorable factors, such as young age and matched related donors, we found a high prevalence of GVDH. Ocular GVHD was less prevalent than expected, and lung GVHD was weakly correlated with established risk factors. Larger multicenter studies are needed to assess and confirm the effect of contributing factors.
来自没有干细胞移植(SCT)设施地区的患者常常前往国外寻求治疗,并回国接受移植后护理。尽管关于移植物抗宿主病(GVHD)及其风险因素已有大量数据,但有关国际SCT患者返回缺乏移植设施和专业知识国家的信息却很少,且记录不完整。
我们筛查了149名移植受者,并分析了2019年1月至2022年12月期间在国外接受移植并在我们中心接受随访的91名患者的数据。这项观察性研究使用了电子病历数据,并采用描述性统计、推断性检验以及带有森林图的相对风险计算来分析GVHD的患病率及其关键风险因素。
在这些受者中,31.8%是居住在阿联酋的九个国家的居民,67.2%是阿联酋公民。成年人占受者的48.3%,而儿科患者占51.7%。血液系统恶性肿瘤是最常见的适应症(49%),主要见于成年人。同胞供者占大多数(52.6%),其次是相关供者(23.09%)和无关供者(8.9%)。大多数患者(69.2%)接受了HLA配型相合的移植,其次是21.9%接受了单倍型相合移植的患者。在成年人中,62.2%发生了GVHD,而儿科患者为26%。来自HLA配型相合相关供者的受者GVHD患病率为50%,而来自无关配型相合供者的受者患病率为71%。在接受异基因SCT的患者中,87.9%的患者GVHD总体患病率为50%。
尽管存在诸如年龄小和配型相合相关供者等有利因素,但我们发现GVHD患病率很高。眼部GVHD的患病率低于预期,肺部GVHD与既定风险因素的相关性较弱。需要更大规模的多中心研究来评估和确认促成因素的影响。