The effect of glucose-6-phosphate dehydrogenase deficiency on allogeneic hematopoietic stem cell transplantation in patients with hematological disorders
10.3760/cma.j.cn121090-20231009-00176
- VernacularTitle:葡萄糖-6-磷酸脱氢酶缺乏对血液病患者异基因造血干细胞移植的影响
- Author:
Jia WANG
1
;
Haixia FU
;
Yuanyuan ZHANG
;
Xiaodong MO
;
Tingting HAN
;
Jun KONG
;
Yuqian SUN
;
Meng LYU
;
Wei HAN
;
Huan CHEN
;
Yuhong CHEN
;
Fengrong WANG
;
Chenhua YAN
;
Yao CHEN
;
Jingzhi WANG
;
Yu WANG
;
Lanping XU
;
Xiaojun HUANG
;
Xiaohui ZHANG
Author Information
1. 北京大学人民医院，北京大学血液病研究所，国家血液系统疾病临床医学研究中心，造血干细胞移植治疗血液病北京市重点实验室，北京 100044
- Keywords:
G6PD deficiency;
Allogeneic hematopoietic stem cell transplantation;
Complication;
Prognosis
- From:
Chinese Journal of Hematology
2024;45(2):121-127
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To determine the effect of glucose-6-phosphate-dehydrogenase (G6PD) deficiency on patients’ complications and prognosis following allogeneic stem cell hematopoietic transplantation (allo-HSCT) .Methods:7 patients with G6PD deficiency (study group) who underwent allo-HSCT at Peking University People's Hospital from March 2015 to January 2021 were selected as the study group, and thirty-five patients who underwent allo-HSCT during the same period but did not have G6PD deficiency were randomly selected as the control group in a 1∶5 ratio. Gender, age, underlying diseases, and donors were balanced between the two groups. Collect clinical data from two patient groups and perform a retrospective nested case-control study.Results:The study group consisted of six male patients and one female patient, with a median age of 37 (range, 2-45) years old. The underlying hematologic diseases included acute myeloid leukemia ( n=3), acute lymphocytic leukemia ( n=2), and severe aplastic anemia ( n=2). All 7 G6PD deficiency patients achieved engraftment of neutrophils within 28 days of allo-HSCT, while the engraftment rate of neutrophils was 94.5% in the control group. The median days of platelet engraftment were 21 (6–64) d and 14 (7–70) d ( P=0.113). The incidence rates of secondary poor graft function in the study group and control group were 42.9% (3/7) and 8.6% (3/35), respectively ( P=0.036). The CMV infection rates were 71.4% (5/7) and 31.4% (11/35), respectively ( P=0.049). The incidence rates of hemorrhagic cystitis were 57.1% (4/7) and 8.6% (3/35), respectively ( P=0.005), while the bacterial infection rates were 100% (7/7) and 77.1% (27/35), respectively ( P=0.070). The infection rates of EBV were 14.3% (1/7) and 14.3% (5/35), respectively ( P=1.000), while the incidence of fungal infection was 14.3% (1/7) and 25.7% (9/35), respectively ( P=0.497). The rates of post-transplant lymphoproliferative disease (PTLD) were 0% and 5.7%, respectively ( P=0.387) . Conclusions:The findings of this study indicate that blood disease patients with G6PD deficiency can tolerate conventional allo-HSCT pretreatment regimens, and granulocytes and platelets can be implanted successfully. However, after transplantation, patients should exercise caution to avoid viral infection, complications of hemorrhagic cystitis, and secondary poor graft function.
