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学科主题: 临床医学
题名:
High-Dose Cyclophosphamide Therapy Associated with Diffuse Alveolar Hemorrhage after Allogeneic Hematopoietic Stem Cell Transplantation
作者: Mo, Xiao-Dong; Xu, Lan-Ping; Liu, Dai-Hong; Zhang, Xiao-Hui; Chen, Huan; Chen, Yu-Hong; Han, Wei; Wang, Yu; Wang, Feng-Rong; Wang, Jing-Zhi; Liu, Kai-Yan; Huang, Xiao-Jun1,2
关键词: Diffuse alveolar hemorrhage ; Transplantation ; Cyclophosphamide ; Corticosteroid
刊名: RESPIRATION
发表日期: 2013
DOI: 10.1159/000345592
卷: 86, 期:6, 页:453-461
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Respiratory System
研究领域[WOS]: Respiratory System
关键词[WOS]: BONE-MARROW-TRANSPLANTATION ; LUNG-DISEASE ; RECIPIENTS ; DIAGNOSIS ; CORTICOSTEROIDS ; MICROANGIOPATHY ; COMPLICATIONS
英文摘要:

Background: The occurrence of diffuse alveolar hemorrhage (DAH) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) is rare but severe. There are few reports that have examined the correlation between pre-HSCT chemotherapeutic exposure and DAH. Objectives: We examine the role of pre-HSCT chemotherapeutic exposure, conditioning regimens, pre-HSCT comorbidities and transplant-related complications in the development of DAH after allo-HSCT and evaluate the effect of the high-dose corticosteroid strategy on DAH. Methods: A retrospective nested case-control study was designed. Cases with DAH and controls matched for year of allo-HSCT and length of follow-up were identified from a cohort of 597 patients who underwent allo-HSCT between 2006 and 2011 for acute leukemia. Results: Twenty-two patients suffered from DAH; the mean age at the time of presentation was 30.4 years (+/- 12.9) and the mean time to presentation was 7.8 months (+/- 8.1) post-HSCT. The pre-HSCT cyclophosphamide exposure and the cumulative cyclophosphamide dose were significantly higher among the DAH cases compared with the controls, and the cumulative cyclophosphamide dose of >= 5 g/m(2) was independently associated with DAH (OR = 3.4, p = 0.030). High-dose corticosteroid treatment did not significantly improve survival. Conclusions: From these results we can identify patients who are at a higher risk of developing DAH after allo-HSCT, and we found that high-dose corticosteroid therapy may not alter the poor outcome associated with this syndrome. Copyright (C) 2012 S. Karger AG, Basel

语种: 英语
所属项目编号: 2011AA020105 ; 30971292
项目资助者: National High Technology Research and Development Program of China (Program 863) ; National Natural Science Foundation of China ; American Journal Experts
WOS记录号: WOS:000329924300002
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55078
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Inst Hematol, Beijing 100044, Peoples R China
2.Peking Univ, Peoples Hosp, Beijing Key Lab Hematopoit Stem Cell Transplantat, Beijing 100044, Peoples R China

Recommended Citation:
Mo, Xiao-Dong,Xu, Lan-Ping,Liu, Dai-Hong,et al. High-Dose Cyclophosphamide Therapy Associated with Diffuse Alveolar Hemorrhage after Allogeneic Hematopoietic Stem Cell Transplantation[J]. RESPIRATION,2013,86(6):453-461.
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