摘要
目的探讨异基因外周血干细胞移植（allo-PBSCT）后与长期生存相关的危险因素。方法对2000年6月至2008年12月65例行allo-PBSCT患者进行回顾性分析,选择年龄、性别、移植时疾病状态、供者类型、HLA相合情况、供受者血型、急性移植物抗宿主病（aGVHD）、慢性移植物抗宿主病（cGVHD）、出血性膀胱炎（HC）、巨细胞病毒（CMV）感染10个临床参数进行Cox单因素分析。将在单因素分析中P〈0.05作为有统计学意义的因素进行Cox多因素回归分析。生存率采用Kaplan-Meier曲线。结果除1例患者外,余64例均达稳定植活,0~Ⅰ度aGVHD为29例（45.3%）,Ⅱ~Ⅳ度aGVHD 35例（54.7%）。发生cGVHD共29例（45.3%）,其中局限型cGVHD 9例（31.0%）,广泛型cGVHD 20例（69.0%）。1年总生存率（OS）为64.6%,5年OS为20.5%。随访至2009年12月,33例（50.8%）存活,生存期12~104个月,中位生存期51个月,死亡32例（49.2%）,生存期1~96个月,中位生存期9个月。Cox回归分析移植时疾病状态和重度aGVHD的相对危险度分别是3.440和2.213。结论移植时疾病状态和重度aGVHD是影响造血干细胞移植长期生存的主要危险因素;在合适的疾病状态进行移植、积极防治aGVHD对移植成功非常重要。
Objective To analyze the risk factors related to long-term survival after allogeneic peripheral blood stem cell transplantation（allo-PBSCT）.Methods Sixty-five patients after allo-PBSCT from Jun.2000 to Dec.2008 were retrospectively analyzed.Ten clinical parameters including age,sex,disease status,donor type,HLA matching,donor-recipient blood type,the incidence of acute graft versus host disease（aGVHD）,chronic graft versus host disease（cGVHD）,hemorrhagic cystitis（HC）,cytomegalo virus（CMV） infection were selected for univariate analysis by using Cox regression.Factors with P0.05 were evaluated by Coxs regression.The survival rates were calculated by Kaplan-Meier curve.Results Sixty-four patients achieved sustained graft engraftment except one patient.Twenty-nine patients developed 0-Ⅰ degree aGVHD（45.3%） and 35 patients developed Ⅱ-Ⅳ degree aGVHD（54.7%）.cGVHD occurred in 29 of 65 patients（45.3%）,among which 9 patients（31.0%） were with local cGVHD,20 patients（69.0%） were with extensive cGVHD.The overall survival at one year was 64.6%.The overall survival at 5 years was 20.5%.Follow-up to Dec.2009,33 patients were alive and median survival duration was 51（12-104） months.Thirty-two patients died and median survival duration was 9（1-96） months.The Cox regression analysis showed that the relative risk degrees were 3.440 and 2.213,respectively.Conclusion The disease status at transplantation and severe aGVHD after transplantation were main risk factors affecting long-term survival.It is vital to select the suitable disease status and prevent,as well as treat aGVHD on hematopoietic stem cells transplantation.
出处
《临床荟萃》
CAS
2010年第18期1583-1586,共4页
Clinical Focus
关键词
血液肿瘤
外周血干细胞移植
移植物抗宿主病
存活率分析
危险因素
hematologic neoplasms
peripheral blood stem cell transplantation
acute graft versus host disease
survival analysis
risk factors
