重型地中海贫血单倍体造血干细胞移植后细胞因子释放综合征临床特征分析

doi:10.7499/j.issn.1008-8830.2406036

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Abstract Objective To investigate the clinical characteristics of cytokine release syndrome (CRS) in children with thalassemia major (TM) after haploidentical hematopoietic stem cell transplantation (haplo-HSCT) and their prognosis. Methods A retrospective analysis was performed for the clinical data of 280 children with TM who underwent haplo-HSCT in the Department of Hematology and Oncology, Shenzhen Children's Hospital, from January 2019 to December 2021. According to the CRS criteria, they were divided into two groups: CRS grade <3 (260 children) and CRS grade ≥3 (20 children). The children with TM were analyzed in terms of clinical characteristics of CRS after haplo-HSCT and their prognosis. Results There were significant differences between the two groups in neutrophil engraftment time, clinical manifestations of CRS, and the rate of use of glucocorticoids within 4 days after haplo-HSCT (P=0.012, 0.040, and <0.001 respectively). For the CRS grade <3 group, the incidence rate of acute graft-versus-host disease (aGVHD) was 9.6% within 3 months after transplantation, while no aGVHD was observed in the CRS grade ≥3 group within 3 months after transplantation, but there was no significant difference in the incidence of aGVHD between the two groups within 3 months after transplantation (P=0.146). No transplantation-related death was observed in either group within 3 months after haplo-HSCT. Conclusions The children with CRS grade≥3 have an early neutrophil engraftment time, severe and diverse clinical manifestations of CRS, and a high rate of use of glucocorticoids within 4 days after haplo-HSCT. For these children, early use of low-dose glucocorticoids after transplantation may alleviate CRS response and reduce the incidence of aGVHD, thereby bringing more benefits to the children. CRS after haplo-HSCT has no significant impact on the prognosis of the children.

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	ZHOU Xiao-Hui
	WANG Xiao-Dong
	LIN Qi-Hong
	WANG Chun-Jing
	YANG Chun-Lan
	LI Yue
	ZHANG Xiao-Ling
	ZHANG Yu
	YU Yue
	LIU Si-Xi

Key words： Thalassemia Cytokine release syndrome Haploidentical hematopoietic stem cell transplantation Child

Received: 07 June 2024

Corresponding Authors: Liu S-X , Email: tiger647@126.com; E-mail: tiger647@126.com

Cite this article:

ZHOU Xiao-Hui,WANG Xiao-Dong,LIN Qi-Hong et al. Clinical characteristics of cytokine release syndrome after haploidentical hematopoietic stem cell transplantation for thalassemia major[J]. CJCP, 2024, 26(12): 1301-1307.

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http://www.zgddek.com/EN/10.7499/j.issn.1008-8830.2406036 OR http://www.zgddek.com/EN/Y2024/V26/I12/1301

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