Факторы риска рецидива при аллогенной трансплантации у детей, подростков и молодых взрослых с острым лимфобластным лейкозом

Известно, что после аллогенной трансплантации гемопоэтических клеток (алло-ТГСК) от HLAидентичного сиблинга или неродственного донора у 20‒25 % пациентов с острыми лейкозами наблюдается рецидив основного заболевания.
Цель исследования – проанализировать влияние различных факторов на частоту возникновения рецидивов после алло-ТГСК у пациентов с острым лимфобластным лейкозом.
Изучено влияние таких факторов, как пол и возраст донора на момент трансплантации, пол и возраст реципиента на момент трансплантации, вид и количество предшествующих ТГСК рецидивов, вид кондиционирования, тип трансплантации, источник стволовых клеток, параметры трансплантата, наличие или отсутствие острой (оРТПХ) или хронической (хрРТПХ) реакции трансплантат против хозяина, наличие KIR-аллореактивности естественных киллеров пары донор/реципиент.
Установлено, что возраст пациентов менее 4 лет на момент трансплантации (p = 0,0042), время возникновения рецидива (очень ранний и ранний рецидив) (p = 0,0047), отсутствие оРТПХ (p = 0,0183) или хрРТПХ (p = 0,0384) являются факторами, ассоциированными с риском развития рецидива после алло-ТГСК.

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