[Risk Factors of Primary Poor Graft Function after Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Myeloid Malignancies].

Abstract

Objective: To analyze the risk factors of primary poor graft function (PGF) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myeloid malignancies and the impact of primary PGF on survival.

Methods: The clinical data of 146 patients with myeloid malignancies who underwent allo-HSCT in our hospital from January 2015 to December 2021 were retrospectively studied. Some relevant clinical parameters which may affect the development of primary PGF after allo-HSCT were selected for univariate and multivariate analysis, as well as performed survival analysis.

Results: A total of 9 patients (6.16%) were diagnosed with primary PGF, and their medium age was 37(28-53) years old. Among them, 1 case underwent matched sibling donor HSCT, 1 case underwent matched unrelated donor HSCT, and 7 cases underwent HLA-haploidentical related donor HSCT. Moreover, 5 cases were diagnosed as cytomegalovirus (CMV) infection, and 3 cases as Epstein-Barr virus (EBV) infection. Univariate and multivariate analysis showed that CD34⁺ cell dose <5×10⁶/kg and pre-transplant C-reactive protein (CRP) >10 mg/L were independent risk factors for occurrence of the primary PGF after allo-HSCT in patients with myeloid malignancies. The 3-year overall survival (OS) rate of primary PGF group was 52.5%, which was significantly lower than 82.8% of good graft function group (P < 0.05).

Conclusion: Making sure pre-transplant CRP≤10 mg/L and CD34⁺ cell dose ≥5×10⁶/kg in the graft may have an effect on preventing the occurrence of primary PGF after allo-HSCT. The occurrence of primary PGF may affect the OS rate of transplant patients, and early prevention and treatment are required.