The differential effect of disease status at allogeneic hematopoietic cell transplantation on outcomes in acute myeloid and lymphoblastic leukemia
The differential effect of disease status at allogeneic hematopoietic cell transplantation on outcomes in acute myeloid and lymphoblastic leukemia
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异基因造血细胞移植时疾病状态对急性髓系和淋巴细胞白血病结局的不同影响
DOI：
10.1007/s00277-021-04661-2
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发表时间：
2021
期刊：
影响因子：
3.5
通讯作者：
Yano S
中科院分区：
文献类型：
--
作者：
Yanada M;Konuma T;Yamasaki S;Mizuno S;Hirabayashi S;Nishiwaki S;Uchida N;Doki N;Tanaka M;Ozawa Y;Sawa M;Eto T;Kawakita T;Ota S;Fukuda T;Onizuka M;Kimura T;Atsuta Y;Kako S;Yano S
本研究旨在比较异基因造血细胞移植（HCT）时疾病状态对急性髓系白血病（AML）和急性淋巴细胞白血病（ALL）移植后结果的影响。对日本全国 6901 名 AML 患者和 2469 名 ALL 患者的登记数据进行了分析。在这项研究中，2850 名 (41%)、937 名 (14%)、62 名 (1%) 和 3052 名 (44%) AML 患者以及 1751 名 (71%)、265 名 (11%)、23 名 (1%) 和 430 名 (17%) ALL 患者在第一次完全缓解 (CR1)、第二次完全缓解 (CR2)、第三次或后续 CR 时接受了移植分别为 (CR3 +) 和非 CR。 CR1、CR2、CR3 + 和非 CR 移植患者的 5 年总生存率，AML 患者为 58%、61%、41% 和 26%，ALL 患者为 67%、45%、20% 和 21%。多变量分析显示，CR1和CR2移植的AML患者的复发风险和总体死亡率相似（P= 0.672和P= 0.703），而CR2移植的ALL患者的复发风险和总体死亡率高于CR1移植的患者（两者P< 0.001）。对于这两种疾病，CR3++和非 CR 移植患者的复发和总体死亡率风险均呈阶梯式增加，其中 ALL 患者的相关性比 AML 患者更强。这些结果表明 HCT 时的疾病状态对 AML 和 ALL 移植后结果的影响存在显着差异。需要进一步研究以纳入可测量的残留疾病数据。
This study aimed to compare the effect of disease status at the time of allogeneic hematopoietic cell transplantation (HCT) on post-transplant outcomes between acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Japanese nationwide registry data for 6901 patients with AML and 2469 patients with ALL were analyzed. In this study, 2850 (41%), 937 (14%), 62 (1%), and 3052 (44%) AML patients and 1751 (71%), 265 (11%), 23 (1%), and 430 (17%) ALL patients underwent transplantation in first complete remission (CR1), second CR (CR2), third or subsequent CR (CR3 +), and non-CR, respectively. The probabilities of overall survival at 5 years for patients transplanted in CR1, CR2, CR3 + , and non-CR were 58%, 61%, 41%, and 26% for AML patients and 67%, 45%, 20%, and 21% for ALL patients, respectively. Multivariate analyses revealed that the risks of relapse and overall mortality were similar for AML patients transplanted in CR1 and CR2 (P= 0.672 andP= 0.703), whereas they were higher for ALL patients transplanted in CR2 than for those transplanted in CR1 (P< 0.001 for both). The risks of relapse and overall mortality for those transplanted in CR3 + and non-CR increased in a stepwise manner for both diseases, with the relevance being stronger for ALL than for AML patients. These results suggest a significant difference in the effect of disease status at HCT on post-transplant outcomes in AML and ALL. Further investigation to incorporate measurable residual disease data is warranted.
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DOI：
10.1016/s1470-2045(18)30240-7
发表时间：
2018-07
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Cortes J;Perl AE;Döhner H;Kantarjian H;Martinelli G;Kovacsovics T;Rousselot P;Steffen B;Dombret H;Estey E;Strickland S;Altman JK;Baldus CD;Burnett A;Krämer A;Russell N;Shah NP;Smith CC;Wang ES;Ifrah N;Gammon G;Trone D;Lazzaretto D;Levis M
通讯作者：
Levis M
影响因子：
4.8
作者：
M. Yanada;T. Konuma;Y. Kuwatsuka;T. Kondo;Takahito Kawata;Satoshi Takahashi;N. Uchida;S. Miyakoshi;Masatsugu Tanaka;Y. Ozawa;M. Sawa;H. Nakamae;N. Aotsuka;J. Kanda;M. Takanashi;Y. Kanda;Y. Atsuta;S. Yano
通讯作者：
M. Yanada;T. Konuma;Y. Kuwatsuka;T. Kondo;Takahito Kawata;Satoshi Takahashi;N. Uchida;S. Miyakoshi;Masatsugu Tanaka;Y. Ozawa;M. Sawa;H. Nakamae;N. Aotsuka;J. Kanda;M. Takanashi;Y. Kanda;Y. Atsuta;S. Yano
影响因子：
28.5
作者：
Pavlu, Jiri;Labopin, Myriam;Mohty, Mohamad
通讯作者：
Mohty, Mohamad
影响因子：
45.3
作者：
Araki, Daisuke;Wood, Brent L.;Walter, Roland B.
通讯作者：
Walter, Roland B.
影响因子：
45.3
作者：
Ibrahim, Joseph G.;Chu, Haitao;Chen, Ming-Hui
通讯作者：
Chen, Ming-Hui