Cytogenetic evolution predicts a poor prognosis in acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation
Cytogenetic evolution predicts a poor prognosis in acute myeloid leukemia patients who relapse after allogeneic hematopoietic stem cell transplantation
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细胞遗传学进化预测异基因造血干细胞移植后复发的急性髓系白血病患者预后不良
DOI：
10.1007/s00277-022-05061-w
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发表时间：
2022-12
影响因子：
3.5
通讯作者：
Jianmin Wang
中科院分区：
文献类型：
--
作者：
Ruiqi Li;Ziwei Wang;Yuesheng Zhang;Mengqiao Guo;Xiong Ni;Jie Chen;Li Chen;Lei Gao;Shenglan Gong;Gusheng Tang;Jianmin Yang;Jianmin Wang
异基因造血干细胞移植(allo-HSCT)后复发的急性髓系白血病(AML)患者预后较差。细胞遗传学进化(CGE)已被研究发现对复发白血病的预后有重要影响，但其对AML患者移植后复发的影响仍存在争议。在这项研究中，我们分析了34例AML患者在allo-HSCT后复发，其中14例在白血病复发后出现额外的染色体核型异常(CGE组)，20例患者没有发生异常(非CGE组)。发现CGE组复发时细胞遗传学特征更为复杂，复发时获得异常最常见的是11号染色体。CGE组复发后6个月总生存率(PROS)显著低于非CGE组(21.4%vs50.0%，P= 0.004)。CGE组的2年OS也有恶化趋势(7.1%vs28.6%，P= 0.096)。在多因素分析中，慢性移植物抗宿主病的发生(HR0.27[95%CI，0.11~0.68]，P= 0.006)和低强度FBA调理方案(HR 0.42[95%CI，0.18~0.98]，P= 0.045)是PRO较好的两个独立因素，而CGE(HR 3.16[95%CI，1.42~7.05]，P= 0.005)与较差的PROS相关。总之，CGE与allo-HSCT后复发的AML患者预后不良有关，应注意监测移植后核型变化的重要性。
Acute myeloid leukemia (AML) patients relapsing after allogeneic hematopoietic stem cell transplantation (allo-HSCT) have a poor prognosis. Cytogenetic evolution (CGE) has been investigated and found to have an important impact on the prognosis of relapsed leukemia, but its impact on AML patients relapsing after transplantation remains controversial. In this study, we analyzed 34 AML patients relapsing after allo-HSCT, among whom 14 developed additional abnormalities in chromosomal karyotype after leukemia recurrence (CGE group) and 20 patients did not (non-CGE group). We found that the cytogenetic characteristics were much more complex at relapse in the CGE group, and the acquisition of aberrations at relapse most commonly involved chromosome 11. The 6-month post-relapse overall survival (PROS) of the CGE group was significantly lower than that of the non-CGE group (21.4% versus 50.0%,P= 0.004). The CGE group also showed a trend of worse 2-year OS (7.1% versus 28.6%,P= 0.096). In the multivariate analyses, the occurrence of chronic graft-versus-host disease (HR 0.27 [95% CI, 0.11–0.68],P= 0.006) and a reduced-intensity FBA conditioning regimen (HR 0.42 [95% CI, 0.18–0.98],P= 0.045) were found to be two independent factors for a better PROS, whereas CGE (HR 3.16 [95% CI, 1.42–7.05],P= 0.005) was associated with a worse PROS. In conclusion, CGE was associated with a poor prognosis in AML patients who relapsed after allo-HSCT, and the importance of monitoring karyotype changes after transplantation should be noted.
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影响因子：
4.3
作者：
Thanarajasingam, Gita;Kim, Haesook T.;Cutler, Corey;Ho, Vincent T.;Koreth, John;Alyea, Edwin P.;Antin, Joseph H.;Soiffer, Robert J.;Armand, Philippe
通讯作者：
Armand, Philippe
影响因子：
3.3
作者：
H. Shimizu;A. Yokohama;T. Ishizaki;N. Hatsumi;S. Takada;T. Saitoh;T. Sakura;Y. Nojima;H. Handa
通讯作者：
H. Shimizu;A. Yokohama;T. Ishizaki;N. Hatsumi;S. Takada;T. Saitoh;T. Sakura;Y. Nojima;H. Handa
DOI：
--
发表时间：
2009
期刊：
--
影响因子：
--
作者：
M. Slovak;L. Shaffer
通讯作者：
M. Slovak;L. Shaffer
影响因子：
10.1
作者：
Onecha E;Rapado I;Luz Morales M;Carreño-Tarragona G;Martinez-Sanchez P;Gutierrez X;Sáchez Pina JM;Linares M;Gallardo M;Martinez-López J;Ayala R
通讯作者：
Ayala R
DOI：
10.32388/78qroa
发表时间：
2020-02
期刊：
Definitions
影响因子：
--
作者：
通讯作者：
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