甲基强的松龙干预植入前综合征对造血干细胞移植患儿预后的影响

The Effect of Methylprednisolone Intervention on the Prognosis of Pre-engraftment Syndrome with Hematopoietic Stem Cell Transplantation in Children

目的造血干细胞移植特别是脐血干细胞移植后易发生植入前综合征(PES),本文探讨不同剂量的甲基强的松龙干预造血干细胞移植患儿植入前综合征对移植预后的影响。方法回顾性的分析苏州大学附属儿童医院自2010年以来接受造血干细胞移植的27例患儿植入前综合征的发生率,根据受累部位和严重程度,给予三种不同剂量(分为三组)的甲基强的松龙进行干预。结果 17例患儿发生了植入前综合征,发生率为62.96%。其中脐血移植发生率最高,达到100%,单倍体移植次之(85.7%),同胞全相合移植发生率为12.5%。Kruskal-Wallis H(K)检验结果示,激素处理组,移植相关并发症如急性GVHD、慢性GVHD、感染等无统计学差别,对生存期没有影响。结论甲基强的松龙是造血干细胞移植患儿植入前综合征的有效干预手段,不会增加患儿移植并发症,不影响生存期。

Objective Hematopoietic stem cell transplantation, in particular cord blood stem cell transplantation（CBT） prone to pre-engraftment syndrome（PES）.This article discusses different doses of methylprednisolone intervention on PES with hematopoietic stem cell transplantation（HSCT） in children. Methods Retrospective analysis of the incidence of PES with HSCTof 27 cases of children in Children＇s Hospital of Soochow University since 2010 was performed.Three doses of methylprednisolone（MP）intervention were administrated according to the organ involved and severity. Results 17 cases showed PES which accounted for 62.96%.The incidence rate amongCBT, haploid transplants and sibling matched donor was 100%,85.7% and 12.5%,respectively.Kruskal-Wallis H （K） test was employed to compare the effect of different dose of MP on the prognosis of PES which indicated that there was no significant difference on transplant-related complications such as acute GVHD,chronic GVHD, infection,neither on survival. Conclusion MP is an effective intervention on PES with HSCT, which does not increase incidence of transplant complications and affect survival in children.