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Prognostic significance of early phase donor chimerism after allogeneic peripheral blood stem cell transplantation



Prognostic significance of early phase donor chimerism after allogeneic peripheral blood stem cell transplantation



Zhonghua Xue Ye Xue Za Zhi 39(11): 932-936



目的: 评价清髓性异基因外周血干细胞移植(allo-PBSCT)后早期完全供者嵌合状态(FDC)对患者预后的预测意义。 方法: 回顾性分析2016年2月至2017年7月行清髓性allo-PBSCT治疗的72例血液病患者临床资料。男44例,女28例,中位年龄36.5(4~59)岁。其中同胞全合供者35例、亲缘单倍型相合供者27例、无关供者10例。采用聚合酶链反应扩增短串联重复序列(PCR-STR)检测移植后1、2、3个月受者骨髓的供者细胞嵌合(DC)率。 结果: 全部72例患者中位随访462(47~805)d,其中55例存活,2年总体生存(OS)率为(68.9±7.7)%;45例无病存活,2年无病生存(DFS)率为(59.5±6.3)%;16例复发,中位复发时间为移植后157(32~374)d,2年复发率(RR)为(24.1±5.3)%。40例(55.6%)患者发生急性移植物抗宿主病(aGVHD),中位发生时间为移植后35.5(13~90)d;23例(31.9%)发生慢性GVHD(cGVHD),中位发生时间为移植后169(94~475)d。单因素分析显示患者年龄、性别、供受者血型、供受者性别、是否发生aGVHD和cGVHD均不影响OS、DFS率及RR。移植后2个月达到FDC组患者OS、DFS率均高于未达FDC组[OS:(85.2±6.9)%对(66.1±7.7)%,P=0.051;DFS:(76.7±7.7)%对(48.9±8.1)%,P=0.021],RR低于未达FDC组[(16.6±6.8)%对(30.4±7.8)%,P=0.187]。 结论: 清髓性allo-PBSCT后早期患者是否达到FDC对移植预后具有重要预测价值,移植后2个月达FDC患者OS及DFS率明显高于未达FDC患者。.

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Accession: 065890504

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PMID: 30486591


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