环磷酰胺和马抗胸腺细胞球蛋白与氟达拉滨、减量环磷酰胺和兔抗胸腺细胞球蛋白治疗获得性再生障碍性贫血患者匹配同胞捐献者异基因造血干细胞移植的方案对比。

IF 2.3 4区 医学 Q2 HEMATOLOGY
Expert Review of Hematology Pub Date : 2024-08-01 Epub Date: 2024-07-23 DOI:10.1080/17474086.2024.2381572
Nour Ben Abdeljelil, Insaf Ben Yaiche, Rihab Ouerghi, Lamia Torjemane, Dorra Belloumi, Ines Turki, Sabrine Mekni, Rimel Yousr Kanoun, Tarek Ben Othman, Saloua Ladeb
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引用次数: 0

摘要

背景:异基因造血干细胞移植(allo-HSCT异基因造血干细胞移植(allo-HSCT)是治疗年轻患者获得性再生障碍性贫血(acquired aplastic anemia,AA)的一种可能治愈的方法。本研究的目的是比较环磷酰胺和马抗胸腺细胞球蛋白(Cy-hATG)与氟达拉滨-环磷酰胺和兔ATG(Flu-Cy-rATG)作为获得性再生障碍性贫血异基因造血干细胞移植调理方案的患者预后:对2008年1月至2022年8月期间接受HLA匹配的同胞供者的allo-HSCT,并接受Cy-hATG或Flu-Cy-rATG调理方案的获得性AA患者进行描述性回顾研究:共有121名患者入组。Cy-hATG组和Flu-Cy-rATG组移植失败的累积发生率分别为11.2%和5.3%。两组在急性移植物抗宿主疾病、慢性移植物抗宿主疾病和移植相关死亡率方面没有明显差异。与 Cy-hATG 组相比,Flu-Cy-rATG 组的 CMV 和 EBV 再激活率明显更高(p = 0.008 和 0.035)。中位随访58个月后,两组的估计总存活率、无事件存活率和无移植物排斥存活率无统计学差异:结论:在高风险人群中,Flu-Cy-rATG与Cy-hATG在MSD异基因造血干细胞移植中的疗效相当。结论:在高风险人群中,Flu-Cy-rATG 与 Cy-hATG 用于 MSD 异体 HSCT 的疗效相当,但似乎与病毒感染的重大风险相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cyclophosphamide and horse anti-thymocyte globulin versus fludarabine, reduced cyclophosphamide and rabbit anti-thymocyte globulin conditioning regimen for allogeneic hematopoietic stem cell transplantation from matched sibling donors in patients with acquired aplastic anemia.

Background: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a potentially curative treatment for acquired aplastic anemia (acquired AA) in young patients. The objective of the study was to compare patient outcomes after Cyclophosphamide and horse antithymocyte globulin (Cy-hATG) versus Fludarabine-cyclophosphamide and rabbit ATG (Flu-Cy-rATG) as part of conditioning regimen in allo-HSCT for acquired AA.

Research design and methods: Descriptive retrospective study conducted on patients with acquired AA who received allo-HSCT from HLA-matched sibling donors between January 2008 and August 2022 after conditioning regimen with Cy-hATG or Flu-Cy-rATG.

Results: A total of 121 patients were enrolled. Cumulative incidence of graft failure was 11.2% in Cy-hATG and 5.3% Flu-Cy-rATG group. There were no significant differences between the two groups in terms of acute GVHD, chronic GVHD, and transplant related mortality. Flu-Cy-rATG group was associated with significantly higher CMV and EBV reactivation(s) compared to Cy-hATG group (p = 0.008 and 0.035, respectively). After a median follow-up of 58 months, estimated overall survival, event-free survival, and graft rejection-free survival were not statistically different between the two groups.

Conclusions: In high-risk population, Flu-Cy-rATG is associated with comparable outcomes to Cy-hATG in allo-HSCT from MSD. However, it seems to be associated with significant risk of viral infections.

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来源期刊
CiteScore
4.70
自引率
3.60%
发文量
98
审稿时长
6-12 weeks
期刊介绍: Advanced molecular research techniques have transformed hematology in recent years. With improved understanding of hematologic diseases, we now have the opportunity to research and evaluate new biological therapies, new drugs and drug combinations, new treatment schedules and novel approaches including stem cell transplantation. We can also expect proteomics, molecular genetics and biomarker research to facilitate new diagnostic approaches and the identification of appropriate therapies. Further advances in our knowledge regarding the formation and function of blood cells and blood-forming tissues should ensue, and it will be a major challenge for hematologists to adopt these new paradigms and develop integrated strategies to define the best possible patient care. Expert Review of Hematology (1747-4086) puts these advances in context and explores how they will translate directly into clinical practice.
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