内科理论与实践2025，Vol.20Issue(4)：289-295,7.DOI:10.16138/j.1673-6087.2025.04.05
既往新型冠状病毒感染对多发性骨髓瘤患者自体造血干细胞移植的影响
Effects of prior COVID-19 infection on autologous hematopoietic stem cell transplantation in multiple myeloma patients
摘要
Abstract
Objective To assess the impact of prior COVID-19 infection on clinical outcomes in terms of engraftment,treatment emergent complications,and immune reconstitution in multiple myeloma(MM)patients after autologous hematopoietic stem cell transplantation(auto-HSCT).Methods Data of MM patients who underwent auto-HSCT from July 1,2022,to July 31,2023,in Ruijin Hospital,Shanghai Jiao Tong University School of Medicine were retrospectively analyzed.The clinical indices including engraftment time,transplant-related infection,engraftment syndrome,immunoglobulin reconstitution,circulating lymphocytes composition,and short-term efficacy were compared in the two cohorts who had or had not been infected by COVID-19 prior to auto-HSCT.Results Sixty-three patients were included.Thirty-two recovered from COVID-19 before auto-HSCT and the remaining 31 did not show evidence of COVID-19 infection.No differences were observed across the two groups in the rates of infections,neutrophil engraftment,platelet engraftment,as well as the incidence of engraftment syndrome.Preceding auto-HSCT,the numbers of CD3+T,CD3+CD8+T and CD19+B lymphocytes in patients recovered from COVID-19 were significantly higher than those in COVID-19-free group(P<0.05);however,such a disparity was not present after auto-HSCT.At day 8 post-infusion,interferon(IFN)-γ level of COVID-19 group was higher as compared with that of non-infected group(P=0.011).The rate of polyclonal immunoglobulins recovery in COVID-19-affected cohort was 3.1%,which was lower than that in non-infected patients three months post auto-HSCT(P=0.026),while there was no difference in depth of therapeutic response between the two groups.Conclusions The data indicates that auto-HSCT can be safely administered in MM patients who completely recovered from COVID-19,but their immunoglobulins reconstitution was relatively delayed upon adoptive transfer.Timely and routine intravenous immunoglobin supplements are recommended for minimizing the risk of infection.关键词
新型冠状病毒/多发性骨髓瘤/自体造血干细胞移植/淋巴细胞亚群/免疫球蛋白重建Key words
COVID-19/Multiple myeloma/Autologous hematopoietic stem cell transplantation/Lymphocyte/Immunoglobulin reconstitution分类
医药卫生引用本文复制引用
金诗炜,潘萌萌,许捷,高山,王焰,刘元昉,陶怡,章卫平,糜坚青..既往新型冠状病毒感染对多发性骨髓瘤患者自体造血干细胞移植的影响[J].内科理论与实践,2025,20(4):289-295,7.基金项目
国家自然科学基金项目(82000154) （82000154）
