摘要
目的:分析异基因造血干细胞移植(allo-HSCT)后出血性膀胱炎(HC)的临床特点和危险因素。方法:总结行allo-HSCT的150例患者发生HC的一般临床资料、病毒学检查结果,以及HC与移植物抗宿主病(GVHD)和其他多种因素的关系。使用方差分析和多元线性回归分析进行统计学分析。结果:32例患者发生HC,发生率为21.3%,发生的中位时间是移植后29天,均为晚期发作类型。患者的性别、年龄、疾病分类、疾病状态、性别相合程度、预处理方式(是否含TBI)、移植方式(是否加第三方细胞)、干细胞的单个核细胞和CD34计数、白细胞植入时间、血小板植入时间、EBV病毒血症均与HC发病无关。与HC发病密切相关的因素包括急性GVHD、供受者HLA配型不合、GVHD预防方式含抗胸腺细胞球蛋白和巨细胞病毒血症(均P<0.01)。多因素分析显示,只有急性GVHD是HC发生的独立危险因素。结论:急性GVHD是晚期发生HC的独立危险因素,急性GVHD与晚期发生的HC之间存在一定的因果关系。
Objective：To analyze the clinical features and risk factors of hemorrhagic cystitis （HC） after alloge- neic hematopoietic stem cell transplantation （allo-HSCT）. Method：Clinical data, virological results,and association between HC and GVHD or other factors were analyzed in 150 patients undergoing allo-HSCT. Analysis of variance and multiple linear regressions were used to statistical analyze. Result： HC occurred in 32 of the 150 patients with an incidence of 21.3%. The median time to diagnosis of HC was 29 days after allo-HSCT. All cases were late-onset HC. There was no statistic difference between age, gender, diagnosis, morbid state, sex conformity between recipi- ent and donor,conditioning regimen （with or without TBI）, type of transplant （with or without the third kind of stem cell）,number of MNC and CD34＋ cell,the time of engraftment for WBC and PLT, EBV viremia and the oc- currence of HC. Univariate analysis indicated that acute GVHD, HLA disparity between recipient and donor, ATG usage to prevent GVHD and CMV viremia were associated with HC （P〈 0. 01）. Multiple regression analysis showed only acute GVHD was the independent risk factor associated with HC. Conclusion： Acute GVHD is an in- dependent risk factor of late-onset HC,and there is association between acute GVHD and late-onset HC.
出处
《临床血液学杂志》
CAS
2014年第6期970-972,974,共4页
Journal of Clinical Hematology
关键词
出血性膀胱炎
造血干细胞移植
危险因素
hemorrhagic cystitis
hematopoietic stem cell transplantation
risk factor
