227例异基因造血干细胞移植后迟发性出血性膀胱炎危险因素分析

熊艺颖; 蔡铎; 陈建斌; 罗小华; 唐晓琼; 王欣; 肖青; 张红宾; 王利

doi:10.16016/j.1000-5404.202108044

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227例异基因造血干细胞移植后迟发性出血性膀胱炎危险因素分析

专题报道：造血干细胞移植并发症的基础与临床研究 | 更新时间：2026-01-09

- 227例异基因造血干细胞移植后迟发性出血性膀胱炎危险因素分析
- Risk factors for late-onset hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation: analysis of 227 cases
- 第三军医大学学报 2021年43卷第21期页码：2321-2330
- 作者机构：
  
  400016 重庆，重庆医科大学附属第一医院血液内科
- 作者简介：
  
  [王利，E-mail：liwangls@yahoo.com WANG Li, E-mail: liwangls@yahoo.com
- 基金信息：
  
  重庆市渝中区科委重点项目(20190121);重庆市科卫联合医学科研项目重点项目(2018ZDXM001);重庆市科委基础研究与前沿探索项目(cstc2018jcyjAX0688)
- DOI：10.16016/j.1000-5404.202108044
  中图分类号： R617;R694.3;R733.7
- 收稿：2021-08-08，
  
  修回：2021-09-16，
  
  纸质出版：2021-11-15
- 稿件说明：
移动端阅览
熊艺颖, 蔡铎, 陈建斌, 等. 227例异基因造血干细胞移植后迟发性出血性膀胱炎危险因素分析[J]. 第三军医大学学报, 2021,43(21):2321-2330.

Yiying XIONG, Duo CAI, Jianbin CHEN, et al. Risk factors for late-onset hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation: analysis of 227 cases[J]. Journal of Third Military Medical University, 2021, 43(21): 2321-2330.
熊艺颖, 蔡铎, 陈建斌, 等. 227例异基因造血干细胞移植后迟发性出血性膀胱炎危险因素分析[J]. 第三军医大学学报, 2021,43(21):2321-2330. DOI： 10.16016/j.1000-5404.202108044.

Yiying XIONG, Duo CAI, Jianbin CHEN, et al. Risk factors for late-onset hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation: analysis of 227 cases[J]. Journal of Third Military Medical University, 2021, 43(21): 2321-2330. DOI： 10.16016/j.1000-5404.202108044.

摘要

目的

探讨异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation

allo-HSCT)后迟发性出血性膀胱炎(late-onset hemorrhagic cystitis

LOHC) 发生的危险因素。

方法

回顾性分析2016-2020年在本院行allo-HSCT的227例患者资料，对造血重建的215例患者进行相关单因素和多因素分析，并进行生存分析和亚组分析。

结果

72例(31.7%)患者在移植后中位31(8~80)d中发生LOHC，中位持续时间为24(3~100)d。单因素和多因素分析显示，供受性别不合、强化预处理方案(包含氟达拉滨/克拉屈滨+阿糖胞苷

FA/CA)、巨细胞病毒(cytomegalovirus

CMV)DNA阳性以及急性移植物抗宿主病(acute graft-versus-host disease，aGVHD)会显著增加LOHC的发生率(

值分别为0.025、＜0.001、0.021和0.028)。LOHC的发生会降低患者的总生存期(overall survival，OS；

=0.035)，且合并aGVHD患者的OS比无LOHC及aGVHD的患者差(

=0.005)。针对急性白血病(acute leukemia

AL)的亚组分析显示，移植前疾病处于CR1的患者LOHC发生率较低(

=2.964，95%

：1.255~7.003，

=0.013)。

结论

供受性别不合、强化预处理方案(包含FA/CA)、CMV-DNA阳性以及aGVHD的发生是LOHC发生的危险因素。

Abstract

Objective

To analyze the risk factors of late-onset hemorrhagic cystitis (LOHC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).

Methods

We retrospectively analyzed 227 patients who underwent allo-HSCT in our hospital from 2016 to 2020. Univariate and multivariate analyses were performed in 215 patients with hematopoietic reconstitution for the clinical factors related to LOHC

and survival analysis and subgroup analysis were also carried out.

Results

LOHC occurred in 72 (31.7%) patients at a median 31 (8~80) d after allo-HSCT

for a median duration of 24 (3~100) d. The results of univariate and multivariate analyses indicated that gender incompatibility in donors and recipients

intensified conditioning regimen with fludarabine/cladribine and cytarabine

cytomegalovirus (CMV)-DNA positive and acute graft-versus-host disease (aGVHD) significantly increased the incidence of LOHC (

=0.025

0.001

0.021 and 0.028

respectively). The LOHC patients had a lower overall survival (OS) rate than those without (

=0.035)

moreover

those with aGVHD simultaneously had worse OS rate than those without (

=0.005). Subgroup analysis of acute leukemia (AL) showed that patients in first complete remission (CR1) before allo-HSCT had a lower incidence of LOHC than others (

=2.964

95%

: 1.255~7.003

=0.013).

Conclusion

Gender incompatibility in donors and recipients

intensified conditioning regimen (including FA/CA)

CMV-DNA positive and aGVHD are independent risk factors for LOHC.

关键词

Keywords

references

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