异基因造血干细胞移植术对急性白血病患者甲状腺 功能影响的危险因素研究.

Objective To investigate the incidence and identify risk factors associated with thyroid disease (TD) in patients diagnosed with acute leukemia (AL) following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods Clinical data of 98 AL patients who underwent allo-HSCT for the first time in the Department of Hematology of the First People's Hospital of Yunnan Province from January 2018 to June 2023 were collected and retrospectively analyzed. All AL patients were treated with anti-tumor drugs (excluding immune checkpoint inhibitors) and allo-HSCT, divided into non-TD group (n = 55) and TD group (n = 43) based on whether TD occurred. We collected the patients' general information and laboratory data, analyzed whether there were statistical differences between the two groups, and explored the related risk factors for TD after allo-HSCT treatment. Results Among the 98 AL patients who underwent allo-HSCT, 43 (43.8%) exhibited abnormal thyroid function, including 22 cases of hypothyroidism (comprising clinical and subclinical hypothyroidism), 9 cases of hyperthyroidism (including clinical and subclinical hyperthyroidism), and 12 cases of elevated thyroid antibodies. Univariate analysis of the non-TD group and TD group showed no statistical significance in age, gender, donorrecipient relationship, HLA matching, donor and recipient blood type, neutrophil implantation time and PLT implantation time (P > 0.05). However, there were statistically significant differences in disease type and the presence of concurrent aGVHD (P < 0.05). The binary logistic regression analysis revealed that aGVHD was identified as a significant risk factor for the development of thyroid disorders after transplantation (OR=3.693, 95%CI=1.166～11.699, P < 0.05). Furthermore, when compared to the underlying disease ALL, AML and other AL exhibited a significantly higher susceptibility to thyroid disorders (P < 0.05). Conclusion Hypothyroidism is the most common type of TD caused by allo-HSCT treatment in AL patients, and TD is more likely to occur in acute non-lymphocytic post-transplantation, and patients with aGVHD is a risk factor for TD. [ABSTRACT FROM AUTHOR]