Marker chromosome is a strong poor prognosis factor after allogeneic HSCT for adverse‐risk AML patients
Marker chromosome is a strong poor prognosis factor after allogeneic HSCT for adverse‐risk AML patients
复制标题
标记染色体是不良风险 AML 患者同种异体 HSCT 后的一个强烈的不良预后因素
DOI：
10.1111/ejh.13495
复制
发表时间：
2020
影响因子：
3.1
通讯作者：
Masuko Masayoshi
中科院分区：
文献类型：
--
作者：
Fuse Kyoko;Tanaka Tomoyuki;Shibasaki Yasuhiko;Furukawa Tatsuo;Narita Miwako;Sone Hirohito;Masuko Masayoshi
前言染色体分析是急性髓细胞白血病（AML）危险性分类的必要手段。标记染色体（Marker chromosome，MC）是一种来源于基因组不稳定性的染色体片段，其起源与其他染色体不能区分。尽管AML伴MC（MC+）即使在强化化疗后预后也很差，但其对异基因造血干细胞移植（allo ‐ HSCT）后预后的影响尚不清楚。结果MC阳性14例（8.6%），MC阴性158例（8.6%）。MC+ vs MC-的2年总生存率（OS）为26.8% vs 62.2%（P= .0098）。MC+ vs MC-的2年累积复发率（CIR）为80.4% vs 35.5%（P= .0004）。在不良风险AML（AD‐AML，n = 36）中，AD‐AML/MC+（n = 11）显示2年OS较差（9. 1%，vs AD‐AML/MC− n = 25，58. 3%，P = 0. 0031）和2年CIR较高（89. 6%，vs AD‐AML/MC− 44. 7%，P = 0. 002）。多因素分析显示，MC（HR 3.08，95%CI; 1.02 - 9.29，P = .046）和HCT-CI（HR 3.23，95%CI; 1.00 - 10.4，P = .049）是AD-AML患者发生CIR的独立危险因素。
IntroductionChromosome analysis is necessary for the risk classification of acute myeloid leukemia (AML). Marker chromosome (MC) is a fragmented chromosome whose origin cannot be identified from other chromosomes and originates from marked genomic instability. Although AML with MC (MC+) has a poor prognosis even after intensive chemotherapy, its influence on the outcome after allogeneic hematopoietic stem cell transplantation (allo‐HSCT) is unclear.Objective and MethodsWe retrospectively analyzed 162 AML patients after allo‐HSCT. To evaluate the significance of MC, we compared it with other chromosomal abnormalities.ResultMarker chromosome was detected in 14 (8.6%, MC+) patients (vs MC−, n = 158). The 2‐year overall survival (OS) in MC+ vs MC− was 26.8% vs 62.2% (P= .0098). The 2‐year cumulative incidence of relapse (CIR) in MC+ vs MC− was 80.4% vs 35.5% (P= .0004). Among adverse‐risk AML (AD‐AML, n = 36), AD‐AML/MC+ (n = 11) demonstrated a poorer 2‐year OS (9.1%, vs AD‐AML/MC− n = 25, 58.3%,P= .0031) and higher 2‐year CIR (89.6%, vs AD‐AML/MC− 44.7%,P= .002). In multivariate analysis, MC (HR 3.08, 95% CI; 1.02‐9.29,P= .046) and HCT‐CI (HR 3.23, 95% CI; 1.00‐10.4,P= .049) were independent risk factors for CIR among AD‐AML.ConclusionOur study suggests MC as a new independent factor for chromosome risk classification to further classify AD‐AML.