CFU-GM对异基因造血干细胞移植治疗血液病的预后价值  

Prognostic value of CFU-GM in allogeneic hematopoietic stem cell transplantation for hematological diseases

作　　者：王淼 邱丽媛 胡志英 李龙威 王东出 王卉 Wang Miao;Qiu Liyuan;Hu Zhiying;Li Longwei;Wang Dongchu;Wang Hui(Cell cryopreservation lab,Hebei Yanda Lu Daopei Hospital,Langfang 065201,China)

机构地区：[1]河北燕达陆道培医院细胞冻存室,廊坊065201

出　　处：《中华检验医学杂志》2023年第10期1035-1039,共5页Chinese Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题计划(20220963);河北省医学科学研究课题计划(20232045)。

摘　　要：目的探讨粒细胞-巨噬细胞集落形成单位(CFU-GM)水平对异基因造血干细胞移植(allo-HSCT)患者的预后价值。方法选择2015年2月至2017年1月在河北燕达陆道培医院allo-HSCT的患者73例, 根据移植时接受查体骨髓培养CFU-GM水平将患者分为高CFU-GM组和低CFU-GM组, 随访37.0(12.5, 50.5)个月, 采用χ2检验比较移植后患者的总体生存率(OS)和无复发死亡率(NRM)。采用Kaplan-Meier法对不同CFU-GM水平患者OS和无复发生存(EFS)情况进行生存分析比较。应用Logistic回归模型进行预后影响因素分析。应用Cox回归模型对患者进一步进行预后风险多因素分析。结果与低CFU-GM组比较, 高CFU-GM组OS较高(分别为81.40%和60.00%, χ2=4.067, P=0.044), NRM较低(分别为11.63%和36.67%, χ2=6.474, P=0.011)。与低CFU-GM组比较, 高CFU-GM组OS生存分析时间平均值(分别为57.6和37.1个月, P=0.039)和EFS生存分析时间平均值(分别为61.7和38.5个月, P=0.011)均较高。Logistic回归分析表明, CFU-GM水平和骨髓MNC均为移植患者OS(分别为OR=2.917, 95%CI 1.011~8.418, P=0.048和OR=1.510, 95%CI 1.058~2.154, P=0.023)和EFS(分别为OR=4.400, 95%CI 1.336~14.492, P=0.015和OR=1.447, 95%CI 1.002~2.090, P=0.049)的影响因素。CFU-GM水平是评估EFS的独立风险因素(HR=0.279, 95%CI 0.097~0.805, P=0.018)。骨髓MNC是评估OS的独立风险因素(HR=1.345, 95%CI 1.052~1.720, P=0.018)。结论 CFU-GM水平和骨髓MNC与allo-HSCT预后相关, 高CFU-GM组患者具有更高的EFS。Objective To investigate the prognostic value of colony forming unit-granulocyte and macrophage(CFU-GM)in allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods Seventy-three patients who received allo-HSCT in Hebei Yanda Lu Daopei Hospital from February 2015 to January 2017 were selected.According to the level of CFU-GM from bone marrow(BM)culture at the time of allo-HSCT,the patients were fit into high CFU-GM group and low CFU-GM group.The overall survival rate(OS)and relapse-free mortality rate(NRM)of patients after transplantation were tested byχ²test after a follow-up of 37.0(12.5,50.5)months.Kaplan-Meier method was used to compare OS and event-free survival(EFS)of patients with different CFU-GM levels.Logistic regression model was used to analyze the prognostic factors.Cox regression model was used to further analyze the prognostic risk of patients.Results Compared with the low CFU-GM group,the high CFU-GM group had a higher OS(81.40%vs 60.00%,χ²=4.067,P=0.044)and a lower NRM(11.63%vs 36.67%,χ²=6.474,P=0.011).Compared with the low CFU-GM group,the mean OS time(57.6 and 37.1 months,respectively,P=0.039)and the mean EFS time(61.7 and 38.5 months,respectively,P=0.011)were significantly higher in the high CFU-GM group.Logistic regression analysis showed that both the level of CFU-GM and BM MNC were significant influencing factors of OS(OR=2.917,95%CI 1.011-8.418,P=0.048 and OR=1.510,95%CI 1.058-2.154,P=0.023,respectively)and EFS(OR=4.400,95%CI 1.336-14.492,P=0.015 and OR=1.447,95%CI 1.002-2.090,P=0.049,respectively)after transplantation.The level of CFU-GM was an independent risk factor for evaluating EFS(HR=0.279,95%CI 0.097-0.805,P=0.018).BM MNC was an independent risk factor for OS(HR=1.345,95%CI 1.052-1.720,P=0.018).Conclusion The level of CFU-GM and BM MNC were related to the prognosis of allo-HSCT.The patients in the high CFU-GM group had higher EFS.

关 键 词：集落形成单位 血液病 造血干细胞移植 预后 

分 类 号：R733[医药卫生—肿瘤] R457.7[医药卫生—临床医学]