Current situation and development of hematopoietic cell transplantation centers:A nationwide survey in China

To the Editor:Hematopoietic cell transplantation(HCT)is a vital modality to cure severe hematological disorders.[1]Global or regional summarized data of HCT are annually reported by the Chinese Blood and Marrow Transplantation Registry Group(CBMTRG),European Society for Blood and Marrow Transplantation(EBMT)and Center for International Blood and Marrow Transplant Research(CIBMTR).It is shown that the number of transplants is continuously increasing,particularly in China in recent years.[2]Since the donor accessibility is significantly addressed by the well-established protocol of haplo-identical HCT(haplo-HCT).

69例血栓性血小板减少性紫癜患者的临床特点及疗效分析

回顾性分析2017年10月至2020年10月郑州大学第一附属医院血栓性血小板减少性紫癜(TTP)患者的临床特点、诊治及转归。收集69例成人TTP患者的临床资料,其中男19例、女50例,中位年龄42(18~79)岁。64例可进行PLASMIC评分的患者,53例(82.8%)患者PLASMIC评分为6~7分。21例在治疗前检测血管性血友病因子裂解酶(ADAMTS13)活性,17例ADAMTS13活性<5%,3例为5%~10%,>10%的患者仅1例。69例患者均行血浆置换(PEX)和/或新鲜冰冻血浆输注(PI)治疗,其中43例加用糖皮质激素治疗,另有20例在PEX/PI+糖皮质激素治疗基础上联合利妥昔单抗和/或免疫抑制剂。69例患者中位随访时间12(1~57)个月,治疗后缓解率69.6%,复发率11.6%,2年总生存(OS)率为69.6%±5.5%。对可能影响OS的因素进行单因素及多因素分析,结果显示复发难治是影响OS的独立危险因素,26例复发难治患者2年OS率显著低于43例非复发难治者(41.5%±9.8%比83.7%±5.6%,P<0.001)。复发难治患者预后极差,需及早加用利妥昔单抗和/或免疫抑制剂等治疗以改善生存。