重新评估单倍体移植中的血液制品辐照:单中心视角。

IF 2 4区 医学 Q3 HEMATOLOGY
Hematology Pub Date : 2024-12-01 Epub Date: 2024-10-28 DOI:10.1080/16078454.2024.2420144
Juan Pablo Martínez-Hernández, Yesica A López-Mora, Rosario Salazar-Riojas, Dalila Marisol Alvarado Navarro, Ana Karen Hernández-Navarro, Yair Omar Chavez-Estrada, Andrés Gómez-De León, Cesar Homero Gutierrez-Aguirre, Perla R Colunga-Pedraza, Olga Graciela Cantú-Rodríguez, José Carlos Jaime-Pérez, David Gomez-Almaguer
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引用次数: 0

摘要

研究目的主要目的是调查接受单倍体造血细胞移植(HCT)并接受非辐照白细胞还原血液成分的患者中输血相关移植物抗宿主疾病(TA-GVHD)的发病率。次要目的是描述我们中心采用的过滤器获得的血液制品的白细胞去除结果:回顾性分析2018年至2023年的临床记录,以及2023年6月至11月对血液成分中残留白细胞的前瞻性评估,以确认我们的白细胞去除方法的有效性:结果:共纳入 150 例患者,未报告使用非辐照血液制品后发生 TA-GVHD 的病例。3-4级急性和中重度慢性GVHD的发生率分别为12.7%(19例)和2.7%(4例)。累计死亡发生率为 39.3%(n = 52),总生存期为 3.7 年(CI 95%,3.3- 4.1 年)。白细胞耗竭分析显示,血小板浓缩物和包装红细胞分别减少了99.93%和99.98%:讨论:造血干细胞移植中的TA-GVHD仍是一个令人担忧的问题,传统上使用血液制品辐照来缓解TA-GVHD。最近获得的支持白细胞减少技术的证据对这一需求提出了质疑,尤其是在资源有限的情况下:这些研究结果支持将减低白细胞作为预防 TA-GVHD 的主要措施,同时还具有降低成本的优势。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reassessing blood product irradiation in haploidentical transplantation: a single-center perspective.

Objectives: The main objective was to investigate the incidence of transfusion-associated graft-versus-host disease (TA-GVHD) in patients who underwent haploidentical hematopoietic cell transplants (HCT) and received non-irradiated leukoreduced blood components. The secondary objective was to describe our leukodepletion results in blood products obtained by the filters employed at our center.

Study design and methods: Clinical records from 2018 to 2023 were retrospectively analyzed, along with a prospective evaluation of residual leukocytes in blood components from June to November 2023 in order to confirm effectivity of our leukodepletion method.

Results: 150 patients were included, no cases of TA-GVHD were reported after using non-irradiated blood products. The incidence of grade 3-4 acute and moderate-severe chronic GVHD was 12.7% (n = 19) and 2.7% (n = 4), respectively. The cumulative incidence of death was 39.3% (n = 52) with a 3.7-year overall survival (CI 95%, 3.3- 4.1 years). Leukodepletion analysis showed a reduction of 99.93% in platelet concentrates and 99.98% in packed red blood cells.

Discussion: TA-GVHD in HCT remains a concern traditionally mitigated using blood product irradiation. Recent evidence obtained in favor of leukoreduction techniques question this need, especially in resource-limited settings.

Conclusion: These findings support leukoreduction as a primary TA-GVHD preventive measure,along with the advantage in cost reduction.

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来源期刊
Hematology
Hematology 医学-血液学
CiteScore
2.60
自引率
5.30%
发文量
140
审稿时长
3 months
期刊介绍: Hematology is an international journal publishing original and review articles in the field of general hematology, including oncology, pathology, biology, clinical research and epidemiology. Of the fixed sections, annotations are accepted on any general or scientific field: technical annotations covering current laboratory practice in general hematology, blood transfusion and clinical trials, and current clinical practice reviews the consensus driven areas of care and management.
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