Evaluation of risk for bronchiolitis obliterans syndrome after allogeneic hematopoietic cell transplantation with myeloablative conditioning regimens.

IF 4.5 2区医学 Q1 HEMATOLOGY Bone Marrow Transplantation Pub Date : 2024-09-27 DOI:10.1038/s41409-024-02422-z

Jesús Duque-Afonso, Paraschiva Rassner, Kristin Walther, Gabriele Ihorst, Claudia Wehr, Reinhard Marks, Ralph Wäsch, Hartmut Bertz, Thomas Köhler, Björn Christian Frye, Daiana Stolz, Robert Zeiser, Jürgen Finke, Kristina Maas-Bauer

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Abstract

Bronchiolitis obliterans syndrome (BOS), as chronic manifestation of graft-versus-host disease (GVHD), is a debilitating complication leading to lung function deterioration in patients after allogeneic hematopoietic cell transplantation (allo-HCT). In the present study, we evaluated BOS development risk in patients after receiving myeloablative conditioning (MAC) regimens. We performed a retrospective analysis of patients undergoing allo-HCT, who received MAC with busulfan/cyclophosphamid (BuCy, n = 175) busulfan/fludarabin (FluBu4, n = 29) or thiotepa/busulfan/fludarabine (TBF MAC, n = 37). The prevalence of lung disease prior allo-HCT, smoking status, GvHD prophylaxis, HCT-CI score, EBMT risk score and GvHD incidence varied across the groups. The cumulative incidence of BOS using the NIH diagnosis consensus criteria at 2 years after allo-HCT was 8% in FluBu4, 23% in BuCy and 19% in TBF MAC (p = 0.07). In the multivariate analysis, we identified associated factors for time to BOS such as FEV1

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异基因造血细胞移植后采用髓鞘消融调理方案的支气管炎闭塞综合征风险评估。

支气管炎闭塞综合征（BOS）是移植物抗宿主病（GVHD）的慢性表现，是导致异基因造血细胞移植（allo-HCT）患者肺功能恶化的一种衰弱性并发症。在本研究中，我们评估了接受髓脱落调理（MAC）方案后患者发生 BOS 的风险。我们对接受allo-HCT的患者进行了一项回顾性分析，这些患者接受的MAC方案包括丁硫安/环磷酰胺（BuCy，175人）、丁硫安/氟达拉滨（FluBu4，29人）或硫特帕/丁硫安/氟达拉滨（TBF MAC，37人）。allo-HCT前肺部疾病的患病率、吸烟状况、GvHD预防措施、HCT-CI评分、EBMT风险评分和GvHD发生率在各组间存在差异。根据 NIH 诊断共识标准，allo-HCT 后 2 年的 BOS 累计发生率在 FluBu4 中为 8%，在 BuCy 中为 23%，在 TBF MAC 中为 19%（P = 0.07）。在多变量分析中，我们发现了与 BOS 发生时间相关的因素，如 FEV1

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来源期刊

Bone Marrow Transplantation 医学-免疫学

CiteScore

8.40

自引率

8.30%

发文量

337

审稿时长

6 months

期刊介绍： Bone Marrow Transplantation publishes high quality, peer reviewed original research that addresses all aspects of basic biology and clinical use of haemopoietic stem cell transplantation. The broad scope of the journal thus encompasses topics such as stem cell biology, e.g., kinetics and cytokine control, transplantation immunology e.g., HLA and matching techniques, translational research, and clinical results of specific transplant protocols. Bone Marrow Transplantation publishes 24 issues a year.