文章：

慢性 GVHD 患者血栓栓塞事件发生率高：与 GVHD 严重程度及供受者 ABO 血型相关

High incidence of thromboembolism in patients with chronic GVHD: association with severity of GVHD and donor-recipient ABO blood group

原文发布日期：2021-05-18

DOI: 10.1038/s41408-021-00488-2

类型: Article

开放获取: 是

英文摘要：

Chronic graft-versus-host disease (cGVHD) after allogeneic hematopoietic cell transplantation (HCT) is associated with systemic inflammation and endothelial dysfunction, increasing risk for thromboembolic events (TEE). In 145 adult recipients who developed cGVHD after a matched sibling or umbilical cord blood donor HCT from 2010 to 2018, 32(22%) developed at least 1 TEE event, and 14(10%) developed 2 TEE events. The 5-year cumulative incidence of TEE was 22% (95% CI, 15–29%) with a median time from cGVHD to TEE of 234 days (range, 12–2050). Median time to the development of LE DVT or PE was 107 (range, 12–1925) compared to 450 days (range, 158–1300) for UE DVT. Cumulative incidence of TEE was 9% (95% CI, 0–20%), 17% (95% CI, 9–25%), and 38% (95% CI, 22–55%) in those with mild, moderate, and severe GVHD, respectively. Higher risk for TEE was associated with cGVHD severity (hazard ratio [HR] 4.9, [95% CI, 1.1–22.0]; p = 0.03), non-O-donor to recipient ABO match compared to O-donor to O-recipient match (HR 2.7, [95% CI, 1.0–7.5]; p = 0.053), and personal history of coronary artery disease (HR 2.4, [95% CI, 1.1–5.3]; p = 0.03). TEE was not associated with 2-year non-relapse mortality or 5-year overall survival.
 

摘要翻译： 

异基因造血细胞移植（HCT）后发生的慢性移植物抗宿主病（cGVHD）与全身性炎症和内皮功能障碍相关，这会增加血栓栓塞事件（TEE）的风险。在2010年至2018年间接受匹配同胞或脐带血供体HCT后发生cGVHD的145名成年受者中，32人（22%）至少发生1次TEE事件，14人（10%）发生了2次TEE事件。TEE的5年累积发生率为22%（95% CI，15–29%），从cGVHD到TEE发生的中位时间为234天（范围：12–2050天）。发生下肢深静脉血栓或肺栓塞的中位时间为107天（范围：12–1925天），而上肢深静脉血栓的中位时间为450天（范围：158–1300天）。在轻度、中度和重度GVHD患者中，TEE的累积发生率分别为9%（95% CI，0–20%）、17%（95% CI，9–25%）和38%（95% CI，22–55%）。较高的TEE风险与cGVHD严重程度（风险比[HR] 4.9，[95% CI，1.1–22.0]；p=0.03）、非O型供体与受体ABO匹配（相较于O型供体对O型受体匹配，HR 2.7，[95% CI，1.0–7.5]；p=0.053）以及个人冠心病史（HR 2.4，[95% CI，1.1–5.3]；p=0.03）相关。TEE与2年非复发死亡率或5年总生存率无显著关联。

原文链接：

High incidence of thromboembolism in patients with chronic GVHD: association with severity of GVHD and donor-recipient ABO blood group