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Effects of recombinant thrombomodulin on long-term prognosis after allogeneic hematopoietic stem cell transplantation.
Transplant Immunology ( IF 1.5 ) Pub Date : 2019-10-27 , DOI: 10.1016/j.trim.2019.101247
Shosaku Nomura 1 , Akiko Konishi 1 , Yukie Tsubokura 1 , Yoshiko Azuma 1 , Masaaki Hotta 1 , Hideaki Yoshimura 1 , Takahisa Nakanishi 1 , Shinya Fujita 1 , Atsushi Satake 1 , Yuta Katayama 2 , Shuichi Ohta 3 , Kunio Hayashi 4 , Kazuyoshi Ishii 1 , Tomoki Ito 1
Affiliation  

We investigated the effects of early recombinant thrombomodulin (rTM) treatment on long-term prognosis after hematopoietic stem cell transplantation (HSCT). Subjects included 300 patients who underwent allogeneic HSCT (131 in the rTM(+) group and 169 in the rTM(−) group). The control group received heparin or no anti-coagulation therapy. When we examined patients with confirmed complications (day 1–100), the frequencies of acute graft-versus-host disease (aGVHD) and thrombotic microangiopathy (TMA) were significantly lower in the rTM(+) group, while the frequencies of veno-occlusive disease did not show such differences. rTM administration was associated with significant differences in the cumulative incidence of aGVHD (any grade and II-IV grades) and TMA. The cumulative overall survival probability was significantly higher in the rTM(+) group (42.3% versus 26.2%, p = .037). Therefore, some causes of a poor prognosis included aGVHD and TMA. The present findings suggest that rTM plays a preventive role in transplant-related complications, such as aGVHD and TMA, after allogeneic HSCT.



中文翻译:

重组血栓调节蛋白对异基因造血干细胞移植后长期预后的影响。

我们调查了早期重组血栓调节蛋白(rTM)治疗对造血干细胞移植(HSCT)后长期预后的影响。受试者包括300名接受了异基因HSCT的患者(rTM(+)组为131名,rTM(-)组为169名)。对照组接受肝素治疗或不接受抗凝治疗。当我们检查已确诊并发症的患者(第1-100天)时,rTM(+)组的急性移植物抗宿主病(aGVHD)和血栓性微血管病(TMA)的发生率明显降低,而静脉输注闭塞性疾病没有显示出这种差异。rTM给药与aGVHD(任何级别和II-IV级)和TMA的累积发生率显着不同有关。rTM(+)组的累积总体生存概率显着更高(42。p  = .037)。因此,一些预后不良的原因包括aGVHD和TMA。目前的发现表明,异体造血干细胞移植后,rTM在移植相关并发症如aGVHD和TMA中起预防作用。

更新日期:2019-10-27
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