Peter A von dem Borne, Berit M Kemps-Mols, Liesbeth C de Wreede, Adriaan A van Beek, Tjeerd J F Snijders, Daniëlle van Lammeren, Janneke Tijmensen, Aniko Sijs-Szabó, Mirjam A Oudshoorn, Constantijn J M Halkes, Peter van Balen, W A Erik Marijt, Jennifer M L Tjon, Joost S P Vermaat, Hendrik Veelken
{"title":"HLA配型程度决定了配型亲缘和非亲缘异体干细胞移植中细胞因子释放综合征的发生率和相关的非复发死亡率,移植后使用环磷酰胺。","authors":"Peter A von dem Borne, Berit M Kemps-Mols, Liesbeth C de Wreede, Adriaan A van Beek, Tjeerd J F Snijders, Daniëlle van Lammeren, Janneke Tijmensen, Aniko Sijs-Szabó, Mirjam A Oudshoorn, Constantijn J M Halkes, Peter van Balen, W A Erik Marijt, Jennifer M L Tjon, Joost S P Vermaat, Hendrik Veelken","doi":"10.1080/10428194.2024.2344060","DOIUrl":null,"url":null,"abstract":"<p><p>Cytokine release syndrome (CRS) occurs frequently after haplo-identical allogeneic stem cell transplantation (alloSCT) with post-transplant cyclophosphamide (PTCy), increasing nonrelapse mortality (NRM) and decreasing survival. Data on CRS in HLA-matched alloSCT are limited and effects of specific HLA-mismatches on CRS development unknown. We hypothesized that in HLA-matched alloSCT increasing degrees of HLA-mismatching influence CRS incidence, NRM and survival. Retrospective analysis of 126 HLA-matched PTCy-alloSCT patients showed that higher degrees of HLA-mismatching significantly increased CRS incidence (26%, 75% and 90% CRS with 12/12, 10/10 and 9/10 matched donors, respectively). Maximum temperature during CRS increased with higher HLA-mismatch. Specific associations between HLA-mismatches and CRS could be determined. Grade 2 CRS and CRS-induced grade 3 fever were associated with significantly increased NRM (<i>p</i> < 0.001 and <i>p</i> = 0.003, respectively) and inferior survival (<i>p</i> < 0.001 and <i>p</i> = 0.005, respectively). NRM was mainly caused by disease conditions that may be considered CRS-induced inflammatory responses (encephalopathy, cryptogenic organizing pneumonia and multi-organ failure).</p>","PeriodicalId":18047,"journal":{"name":"Leukemia & Lymphoma","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The degree of HLA matching determines the incidence of cytokine release syndrome and associated nonrelapse mortality in matched related and unrelated allogeneic stem cell transplantation with post-transplant cyclophosphamide.\",\"authors\":\"Peter A von dem Borne, Berit M Kemps-Mols, Liesbeth C de Wreede, Adriaan A van Beek, Tjeerd J F Snijders, Daniëlle van Lammeren, Janneke Tijmensen, Aniko Sijs-Szabó, Mirjam A Oudshoorn, Constantijn J M Halkes, Peter van Balen, W A Erik Marijt, Jennifer M L Tjon, Joost S P Vermaat, Hendrik Veelken\",\"doi\":\"10.1080/10428194.2024.2344060\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Cytokine release syndrome (CRS) occurs frequently after haplo-identical allogeneic stem cell transplantation (alloSCT) with post-transplant cyclophosphamide (PTCy), increasing nonrelapse mortality (NRM) and decreasing survival. Data on CRS in HLA-matched alloSCT are limited and effects of specific HLA-mismatches on CRS development unknown. We hypothesized that in HLA-matched alloSCT increasing degrees of HLA-mismatching influence CRS incidence, NRM and survival. Retrospective analysis of 126 HLA-matched PTCy-alloSCT patients showed that higher degrees of HLA-mismatching significantly increased CRS incidence (26%, 75% and 90% CRS with 12/12, 10/10 and 9/10 matched donors, respectively). Maximum temperature during CRS increased with higher HLA-mismatch. Specific associations between HLA-mismatches and CRS could be determined. Grade 2 CRS and CRS-induced grade 3 fever were associated with significantly increased NRM (<i>p</i> < 0.001 and <i>p</i> = 0.003, respectively) and inferior survival (<i>p</i> < 0.001 and <i>p</i> = 0.005, respectively). NRM was mainly caused by disease conditions that may be considered CRS-induced inflammatory responses (encephalopathy, cryptogenic organizing pneumonia and multi-organ failure).</p>\",\"PeriodicalId\":18047,\"journal\":{\"name\":\"Leukemia & Lymphoma\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Leukemia & Lymphoma\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/10428194.2024.2344060\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/5/6 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Leukemia & Lymphoma","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10428194.2024.2344060","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/6 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
单倍体同种异体干细胞移植(alloSCT)后,移植后环磷酰胺(PTCy)会经常出现细胞因子释放综合征(CRS),增加非复发死亡率(NRM),降低存活率。有关HLA匹配异体干细胞移植中CRS的数据有限,特定HLA错配对CRS发展的影响尚不清楚。我们假设,在 HLA 匹配的异体干细胞移植中,HLA 错配程度的增加会影响 CRS 的发生率、NRM 和存活率。对126例HLA匹配的PTCy-alloSCT患者进行的回顾性分析表明,HLA不匹配程度越高,CRS发生率越高(12/12、10/10和9/10匹配供者的CRS发生率分别为26%、75%和90%)。CRS期间的最高体温随HLA错配程度的升高而升高。HLA错配与CRS之间的具体关系可以确定。2 级 CRS 和 CRS 引起的 3 级发热与 NRM 的显著增加(分别为 p p = 0.003)和存活率的降低(分别为 p p = 0.005)有关。NRM主要由可被视为CRS诱发炎症反应的疾病状况(脑病、隐源性有组织肺炎和多器官功能衰竭)引起。
The degree of HLA matching determines the incidence of cytokine release syndrome and associated nonrelapse mortality in matched related and unrelated allogeneic stem cell transplantation with post-transplant cyclophosphamide.
Cytokine release syndrome (CRS) occurs frequently after haplo-identical allogeneic stem cell transplantation (alloSCT) with post-transplant cyclophosphamide (PTCy), increasing nonrelapse mortality (NRM) and decreasing survival. Data on CRS in HLA-matched alloSCT are limited and effects of specific HLA-mismatches on CRS development unknown. We hypothesized that in HLA-matched alloSCT increasing degrees of HLA-mismatching influence CRS incidence, NRM and survival. Retrospective analysis of 126 HLA-matched PTCy-alloSCT patients showed that higher degrees of HLA-mismatching significantly increased CRS incidence (26%, 75% and 90% CRS with 12/12, 10/10 and 9/10 matched donors, respectively). Maximum temperature during CRS increased with higher HLA-mismatch. Specific associations between HLA-mismatches and CRS could be determined. Grade 2 CRS and CRS-induced grade 3 fever were associated with significantly increased NRM (p < 0.001 and p = 0.003, respectively) and inferior survival (p < 0.001 and p = 0.005, respectively). NRM was mainly caused by disease conditions that may be considered CRS-induced inflammatory responses (encephalopathy, cryptogenic organizing pneumonia and multi-organ failure).
期刊介绍:
Leukemia & Lymphoma in its fourth decade continues to provide an international forum for publication of high quality clinical, translational, and basic science research, and original observations relating to all aspects of hematological malignancies. The scope ranges from clinical and clinico-pathological investigations to fundamental research in disease biology, mechanisms of action of novel agents, development of combination chemotherapy, pharmacology and pharmacogenomics as well as ethics and epidemiology. Submissions of unique clinical observations or confirmatory studies are considered and published as Letters to the Editor