Ljungman P, Hassan M, Békássy A N, Ringdén O, Oberg G
Department of Medicine, Huddinge University Hospital, Sweden.
Bone Marrow Transplant. 1995 Jun;15(6):869-71.
Alopecia is an important long-term complication after bone marrow transplantation (BMT). The aim of this study was to analyze the influence of busulfan concentration on the development of permanent alopecia. Sixty five patients who survived for at least 6 months after BMT were studied. The median follow-up was 2.1 years (range 0.5-5.7 years). Thirty one patients (47%) had some degree of alopecia and 19 of these patients had extensive alopecia. The mean minimum busulfan concentration was 656 +/- 222 ng/ml in patients who developed alopecia compared with 507 +/- 224 ng/ml in those who did not (P = 0.005). Patients with more extensive alopecia had higher busulfan concentrations than patients with less significant abnormalities. In multivariate analysis, alopecia was associated with busulfan concentrations higher than the median (OR 3.43; 95% CI 3.04-3.88), allogeneic transplantation (OR 2.56; 95% CI 2.28-2.88) and female sex (OR 1.96; 95% CI 1.73-2.88). There was no association between alopecia and chronic graft-versus-host disease. High busulfan concentrations may contribute to the development of permanent alopecia and the risk for alopecia should be considered when choosing the conditioning regimen before BMT.
脱发是骨髓移植（BMT）后一种重要的长期并发症。本研究的目的是分析白消安浓度对永久性脱发发生的影响。对65例BMT后存活至少6个月的患者进行了研究。中位随访时间为2.1年（范围0.5 - 5.7年）。31例患者（47%）有一定程度的脱发，其中19例患者有广泛脱发。发生脱发的患者白消安平均最低浓度为656±222 ng/ml，未发生脱发的患者为507±224 ng/ml（P = 0.005）。脱发较广泛的患者白消安浓度高于异常程度较轻的患者。在多变量分析中，脱发与高于中位数的白消安浓度（比值比3.43；95%可信区间3.04 - 3.88）、异基因移植（比值比2.56；95%可信区间2.28 - 2.88）和女性性别（比值比1.96；95%可信区间1.73 - 2.88）相关。脱发与慢性移植物抗宿主病之间无关联。高白消安浓度可能导致永久性脱发的发生，在BMT前选择预处理方案时应考虑脱发风险。
