移植前纤维化-4（FIB-4）指数对成人非亲缘单股脐带血移植后非复发和总死亡率的预后价值。

IF 1.7 4区医学 Q3 HEMATOLOGY

Acta Haematologica Pub Date : 2024-08-28 DOI:10.1159/000541157

Takaaki Konuma, Maki Monna-Oiwa, Seiko Kato, Masamichi Isobe, Satoshi Takahashi, Yasuhito Nannya

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引用次数: 0

摘要

简介肝纤维化-4（FIB-4）指数是肝纤维化的无创标志物。FIB-4 指数可预测肝病和非肝病患者的不良预后。然而，FIB-4指数与脐带血移植（CBT）后死亡率和肝脏相关临床结果的关系尚不清楚：方法：我们回顾性评估了本院336名单体非亲缘脐带血移植成人的移植前FIB-4指数对预后的影响：结果：在多变量分析中，以FIB-4指数1.3组为参照，FIB-4指数1.3-2.67组（危险比[HR]，2.51；95%置信区间[CI]，1.19-5.30）和FIB-4指数2.67组（HR，2.34；95%置信区间，1.12-4.90）的非复发死亡率显著较高。FIB-4指数>2.67组的总死亡率明显较高（HR，1.66；95% CI，1.00-2.73），但FIB-4指数1.3-2.67组的总死亡率仅略有差异（HR，1.59；95% CI，0.96-2.64）。造血功能恢复、急性和慢性肝脏移植物抗宿主疾病以及静脉闭塞症/鼻窦阻塞综合征与移植前FIB-4指数无关：结论：移植前FIB-4指数可准确预测接受单体非相关性CBT的成年患者的死亡率。

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Prognostic Value of the Pretransplant Fibrosis-4 Index on Non-Relapse and Overall Mortality following Unrelated Single-Unit Cord Blood Transplantation in Adults.

Introduction: The fibrosis-4 (FIB-4) index is a noninvasive marker of liver fibrosis. The FIB-4 index predicts poor outcomes in patients with hepatic and non-hepatic diseases. However, the association of the FIB-4 index with mortality and liver-related clinical outcomes following cord blood transplantation (CBT) is unclear.

Methods: We retrospectively evaluated the impact of the pretransplant FIB-4 index on outcomes in 336 adults following single-unit unrelated CBT at our institution.

Results: In multivariate analyses, when the FIB-4 index <1.3 group was used as the reference, non-relapse mortality was significantly higher in the FIB-4 index 1.3-2.67 (hazard ratio [HR], 2.51; 95% confidence interval [CI], 1.19-5.30) and FIB-4 index >2.67 (HR, 2.34; 95% CI, 1.12-4.90) groups. Overall mortality was significantly higher in the FIB-4 index >2.67 group (HR, 1.66; 95% CI, 1.00-2.73), but with only marginal significance in the FIB-4 index 1.3-2.67 group (HR, 1.59; 95% CI, 0.96-2.64). Hematopoietic recovery, acute and chronic graft-versus-host disease of the liver, and veno-occlusive disease/sinusoidal obstruction syndrome were not associated with the pretransplant FIB-4 index.

Conclusion: The pretransplant FIB-4 index is accurate and useful in predicting mortality in adult patients undergoing single-unit unrelated CBT.

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来源期刊

Acta Haematologica 医学-血液学

CiteScore

4.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Acta Haematologica'' is a well-established and internationally recognized clinically-oriented journal featuring balanced, wide-ranging coverage of current hematology research. A wealth of information on such problems as anemia, leukemia, lymphoma, multiple myeloma, hereditary disorders, blood coagulation, growth factors, hematopoiesis and differentiation is contained in first-rate basic and clinical papers some of which are accompanied by editorial comments by eminent experts. These are supplemented by short state-of-the-art communications, reviews and correspondence as well as occasional special issues devoted to ‘hot topics’ in hematology. These will keep the practicing hematologist well informed of the new developments in the field.