JCO：关注淋巴瘤患者自体造血干细胞移植后心脏损伤

2015-07-22 大鹏译医学论坛网

最新研究显示，淋巴瘤患者在接受自体造血干细胞移植后容易出现左心室收缩功能不全(LVSD)，其风险是正常人群的6至7倍。该研究论文发表于6月份的《临床肿瘤学杂志》(Journal of Clinical Oncology)。该研究入组了1987年至2008年挪威接受自体造血干细胞移植的淋巴瘤患者，入组患者均完成了调查问卷，并接受了心功能相关检查。同时，研究者通过医院注册系统获得了患者治疗详情。

最新研究显示，淋巴瘤患者在接受自体造血干细胞移植后容易出现左心室收缩功能不全(LVSD)，其风险是正常人群的6至7倍。该研究论文发表于6月份的《临床肿瘤学杂志》(Journal of Clinical Oncology)。

该研究入组了1987年至2008年挪威接受自体造血干细胞移植的淋巴瘤患者，入组患者均完成了调查问卷，并接受了心功能相关检查。同时，研究者通过医院注册系统获得了患者治疗详情。

研究者定义LVSD的标准：超声检查左室射血分数低于50%。研究者使用美国心脏病学会/美国心脏协会制定的标准评估心衰情况。

统计结果显示，约15.7%的淋巴瘤术后患者存在LVSD，这其中约三分之一为(占总样本的5.1%)存在无症状性LVSD，其最高氧耗量与正常人相似，具有一定的诊断迷惑性。10.6%(29例)患者存在心衰，多数为纽约心脏协会(NYHA)Ⅱ级心衰。出现严重心衰的患者均接受过心脏放射及蒽环类药物治疗。

另外，研究者发现超过300 mg/m²的阿霉素治疗与高剂量放射治疗是患者LVSD的独立风险因素。

关注淋巴瘤患者的心脏预后

研究者指出，“在干细胞治疗后的淋巴瘤患者群体，LVSD是一项常见的晚期预后，约六分之一的患者会出现LVSD，因此，我们应降低此类患者接受心脏专业治疗的‘门槛’，即使是微小的症状也应引起我们的警惕。”同时，“对于一些接受心脏毒性药物治疗的亚群，我们或许需要进行某些常规监测。”

该研究也为改善淋巴瘤患者预后心功能提供了思路，例如，控制蒽环类药物(阿霉素)剂量、调节放射治疗方案、定期随访心功能等。

总之，该研究揭示了淋巴瘤患者存在的预后心血管风险，这种左室隐患即使在患者治疗成功后的多年时间内都不应被忽视。

原始出处

Veronica Hackethal.Heart Damage in Patients With Lymphoma After Stem Cell Transplant.medscape.July 16, 2015

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2016-03-01 lidong40

#JCO#

38 0
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2015-10-25 limedical1982

#细胞移植#

25 0
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2015-07-24 huanbaofeng

#造血干细胞#

39 0
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2015-07-24 智者为医08

#损伤#

24 0
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2015-07-24 zhouqu_8

#心脏损伤#

0 0
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2015-07-24 俅侠

#造血#

27 0
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2015-07-24 dongjia2014

#自体造血干细胞移植#

28 0

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