同种异体干细胞移植治疗血液病:十年经验。

Salman Arif, Natasha Ali, Usman Shaikh, Salman Adil, Hamzah Jehanzeb
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引用次数: 0

摘要

背景:同种异体造血细胞移植(Allogeneic hematopoietic cell transplantation, allo-HCT)是一项复杂的手术,有可能为各种血液疾病提供根治性治疗。本研究旨在评估同种异体hct在血液学疾病中的效果,并在单中心环境中确定显著并发症。材料和方法:我们对2011年1月至2021年12月期间接受同种异体hct治疗的180例血液病患者进行了回顾性分析。主要结果包括移植适应症、总生存期、移植时间、复发率、移植物抗宿主病(GVHD)和移植相关死亡率(TRM)。结果:同种异体hct最常见的适应症是良性血液系统疾病,尤其是再生障碍性贫血和重度地中海贫血。尽管大多数患者接受了完全匹配的移植,但在30%的队列中观察到急性GVHD。13例患者发生移植物衰竭,原发性和继发性移植物失败率分别为1.6%和5.5%。脓毒症成为第100天及以后非复发性死亡的主要原因。该研究的总生存率为62%,79%的患者在最后一次就诊时无疾病。结论:本研究通过对多种相关结果的全面概述,为同种异体hct治疗血液系统疾病的治疗策略和患者护理提供了有价值的见解。研究结果强调了解决与同种异体移植相关的并发症和危险因素的重要性,包括GVHD和感染。未来的研究应着眼于进一步优化移植技术,以减少并发症,提高患者生存率。
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Allogeneic Stem Cell Transplant in Hematological Disorders: A Decade of Experience.

Background: Allogeneic hematopoietic cell transplantation (allo-HCT) is a complex procedure with the potential to provide curative treatment for various hematological disorders. This study aims to evaluate the outcomes of allo-HCT in hematological diseases and identify significant complications in a single-center setting. Materials and Methods: We conducted a retrospective analysis of 180 patients with hematological diseases who underwent allo-HCT between January 2011 and December 2021. Key outcomes, including indications for transplantation, overall survival, engraftment time, relapse rates, graft-versus-host disease (GVHD), and transplant-related mortality (TRM) were assessed. Results: The most common indications for allo-HCT were benign hematological diseases, particularly aplastic anemia, and thalassemia major. Despite the majority of patients receiving fully matched transplants, acute GVHD was observed in 30% of the cohort. Graft failure occurred in 13 patients, with primary and secondary graft failure rates of 1.6% and 5.5%, respectively. Sepsis emerged as the primary cause of non-relapsed mortality at day 100 and beyond. The overall survival rate in this study was 62%, with 79% of patients disease-free on their last visit. Conclusion: This study provides valuable insights into the treatment strategies and patient care of allo-HCT for hematological disorders by offering a comprehensive overview of multiple relevant outcomes. The findings underscore the significance of addressing complications and risk factors associated with allogeneic transplantation, including GVHD and infections. Future research should focus on further optimizing transplantation techniques to minimize complications and enhance patient survival.

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