Objective: To explore the incidence and clinical characteristics of engraftment syndrome (ES) after syngeneic hematopoietic stem cell transplantation (syn-HSCT) in patients with hematological diseases. Methods: The clinical data of 21 patients who received syn-HSCT at People's Hospital of Peking University from January 1994 to May 2018 were retrospectively analyzed. Results: Seven (33.3% ) of 21 patients developed ES. The onset of ES symptoms occurred at a median of 8 (range: 5-13) days after HSCT, and the diagnosis of ES occurred at a median of 10 (range: 7-14) days after HSCT. Steroids were administered immediately after the diagnosis of ES, the median time of symptom continuance was 2 (range: 1-5) days, and all patients showed complete resolution of ES symptoms. In the multivariate analysis, patients with acute myeloid leukemia and faster neutrophil reconstitution were the risk factors for ES (HR=15.298, 95% CI 1.486-157.501, P=0.022, and HR=17.459, 95% CI 1.776-171.687, P=0.014) . Meanwhile, there was no significant difference in the overall survival and disease-free survival between patients with ES and those without ES. Conclusion: A high incidence of ES was observed in syn-HSCT recipients. Moreover, the prognosis of ES was excellent.
目的： 探究血液病患者同基因造血干细胞移植（syn-HSCT）后植入综合征（ES）的发生率及其临床特征。 方法： 纳入1994年1月至2018年5月在北京大学人民医院接受syn-HSCT的21例患者，对其临床资料进行回顾性分析。 结果： ①21例患者中男13例，女8例，中位年龄24（4~46）岁。重型再生障碍性贫血2例，骨髓增生异常综合征1例，急性髓系白血病8例，急性淋巴细胞白血病6例，慢性髓性白血病4例。移植后中位随访时间为817（24~5 602）d。②21例syn-HSCT患者中7例（33.3%）发生ES。首次出现ES相关症状的中位时间为移植后8（5~13）d，诊断ES的中位时间为移植后10（7~14）d。所有ES患者均以糖皮质激素治疗并获得完全缓解，中位症状持续时间为2（1~5）d。③多因素分析显示，原发病为急性髓系白血病（HR＝15.298，95%CI 1.486~157.501，P＝0.022）和中性粒细胞植入时间<12 d（HR＝17.459，95%CI 1.776~171.687，P＝0.014）是ES发生的独立危险因素。ES组与未发生ES组移植后总生存率与无病生存率差异无统计学意义。 结论： 血液病患者syn-HSCT后具有较高的ES发生率，但预后较好。.
Keywords: Clinical picture; Engraftment syndrome; Syngeneic hematopoietic stem cell transplantation; syngeneic.