Risk Factors for Secondary Poor Graft Function After Allogeneic Hematopoietic Stem Cell Transplantation in Aplastic Anemia
Objective To investigate the risk factors of secondary poor graft function(sPGF)after allogeneic hematopoietic stem cell transplantation(Allo-HSCT)for aplastic anemia(AA).Methods Clinical data of 213 patients who survived more than 28 days after Allo-HSCT at the Hematopoietic Stem Cell Transplantation Center of the First Affiliated Hospital of Zhengzhou University from January 2016 to June 2021,excluding graft failure,a total of 185 patients were included in the study and divided into the sPGF group and the good graft function(GGF)group.The x2 test and logistic regression were used to analyze the factors that might affect the sPGF.Results Among the 185 AA patients who underwent Allo-HSCT,29 developed sPGF.Statistical analysis showed+12 days without neutrophil engraftment,history of grades Ⅱ-Ⅳ acute graft-versa-host disease(aGVHD)and Epstein-Barr virus(EBV)infection were significant risk factors for sPGF(OR=3.747,P=0.023;OR=5.545,P=0.003;OR=3.314,P=0.026).Survival analysis showed that the 3 years survival rate was significantly lower in the sPGF group than in the GGF group(P＜0.001).Conclusion Patients with sPGF after AA transplantation have a poor prognosis.For patients with+12 days without neutrophil engraftment,history of grades Ⅱ-Ⅳ aGVHD and EBV infection,Early identification and intervention should be performed to improve the efficacy of transplantation.
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