Risk Factors of Primary Poor Graft Function after Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Myeloid Malignancies
10.19746/j.cnki.issn1009-2137.2024.06.037
- VernacularTitle:髓系肿瘤患者异基因造血干细胞移植后原发性植入功能不良的危险因素分析
- Author:
Lin-Yi ZHANG
1
;
Yi-Ying XIONG
;
Ming-Yan LIAO
;
Qing XIAO
;
Xiao-Qiong TANG
;
Xiao-Hua LUO
;
Hong-Bin ZHANG
;
Li WANG
;
Lin LIU
Author Information
1. 重庆医科大学附属第一医院血液内科,重庆 400016
- Keywords:
primary poor graft function;
allogeneic hematopoietic stem cell transplantation;
risk factor;
myeloid malignancy
- From:
Journal of Experimental Hematology
2024;32(6):1875-1881
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors of primary poor graft function (PGF) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myeloid malignancies and the impact of primary PGF on survival. Methods:The clinical data of 146 patients with myeloid malignancies who underwent allo-HSCT in our hospital from January 2015 to December 2021 were retrospectively studied. Some relevant clinical parameters which may affect the development of primary PGF after allo-HSCT were selected for univariate and multivariate analysis,as well as performed survival analysis. Results:A total of 9 patients (6.16％) were diagnosed with primary PGF,and their medium age was 37(28-53) years old. Among them,1 case underwent matched sibling donor HSCT,1 case underwent matched unrelated donor HSCT,and 7 cases underwent HLA-haploidentical related donor HSCT. Moreover,5 cases were diagnosed as cytomegalovirus (CMV) infection,and 3 cases as Epstein-Barr virus (EBV) infection. Univariate and multivariate analysis showed that CD34+cell dose<5×106/kg and pre-transplant C-reactive protein (CRP)>10 mg/L were independent risk factors for occurrence of the primary PGF after allo-HSCT in patients with myeloid malignancies. The 3-year overall survival (OS) rate of primary PGF group was 52.5％,which was significantly lower than 82.8％ of good graft function group (P<0.05). Conclusion:Making sure pre-transplant CRP≤10 mg/L and CD34+cell dose ≥5×106/kg in the graft may have an effect on preventing the occurrence of primary PGF after allo-HSCT. The occurrence of primary PGF may affect the OS rate of transplant patients,and early prevention and treatment are required.
