Risk factors for lymphoproliferative disorders after allogeneic hematopoietic stem cell transplantation in children with thalassemia major
10.3760/cma.j.cn101070-20240418-00245
- VernacularTitle:重型地中海贫血患儿异基因造血干细胞移植后淋巴增殖性疾病的危险因素分析
- Author:
Xiaojuan LUO
1
;
Chunmiao DONG
;
Ke CAO
;
Tao HUANG
;
Chunjing WANG
;
Yue LI
;
Chunlan YANG
;
Zhenmin REN
;
Xiaoying FU
;
Yunsheng CHEN
Author Information
1. 深圳市儿童医院检验科，深圳 518038
- Keywords:
Thalassemia;
Hematopoietic stem cell transplantation;
Post-transplant lymphoproliferative disease;
Risk factor
- From:
Chinese Journal of Applied Clinical Pediatrics
2024;39(12):917-921
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors for lymphoproliferative disorders (PTLD) in children with thalassemia major (TM) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:This was a retrospective case-control study.A total of 482 children with TM who underwent allo-HSCT at Shenzhen Children′s Hospital between January 2020 and December 2022 were selected and classified into the PTLD and non-PTLD groups according to the occurrence of PTLD.The risk factors for PTLD after allo-HSCT in children with TM were analyzed, and the diagnostic efficiency of relevant risk factors for PTLD was analyzed by receiver operating characteristic (ROC) curve.Results:A total of 25 out of 482 patients (5.2%, 25/482) developed PTLD about 114 (54-271) days after allo-HSCT.Among them, 12 cases (12/25, 48.0%) occurred within 100 days, and 22 cases (22/25, 88.0%) occurred within 1 year after allo-HSCT.Univariate analysis showed that there were significant differences in gender composition, type of transplant donor, number of natural killer cells and B lymphocytes in peripheral blood at 30 days after allo-HSCT, positive rate of plasma Epstein-Barr virus deoxyribonucleic acid (EBV-DNA) and incidence rate of acute graft-versus-host disease (aGVHD) between the 2 groups (all P<0.05).Multivariate Logistic regression analysis showed that female ( OR=3.196, 95% CI: 1.144-8.929), positive plasma EBV-DNA ( OR=17.523, 95% CI: 5.449-56.344) and aGVHD ( OR=3.156, 95% CI: 1.161-8.575) were independent risk factors for PTLD after allo-HSCT in TM children (all P<0.05).The ROC curve analysis showed that positive plasma EBV-DNA had an excellent accuracy in predicting the occurrence of PTLD after allo-HSCT (sensitivity was 0.796, specificity was 0.800, area under the curve was 0.803).If combined with aGVHD and gender, the area under the curve for the prediction of PTLD increased to 0.831. Conclusions:Female, positive plasma EBV-DNA and aGVHD are independent risk factors for PTLD after allo-HSCT in children with TM.It provides useful early warnings for the prediction and prevention of PTLD.
