Comparison of outcomes in mixed phenotype acute leukemia patients treated with chemotherapy and stem cell transplantation versus chemotherapy alone
Comparison of outcomes in mixed phenotype acute leukemia patients treated with chemotherapy and stem cell transplantation versus chemotherapy alone
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DOI：
10.1016/j.leukres.2016.04.002
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发表时间：
2016-06-01
影响因子：
2.7
通讯作者：
Wu, Depei
中科院分区：
文献类型：
--
作者：
Tian, Hong;Xu, Yang;Wu, Depei
混合表型急性白血病（MPAL）的最佳治疗方法仍然未知，治疗结果的预后因素需要确定。在这项研究中，66例根据WHO 2008年公布的标准诊断为MPAL的患者进行了回顾性评估，以评估治疗的有效性并确定预测变量。5例患者在首次诱导化疗后死于严重感染，29例患者在诱导后接受了alloHSCT（HSCT组），32例患者仅接受化疗（化疗组）。整个队列的3年OS和DFS估计值分别为45%和38%，HSCT组和单纯化疗组的3年OS差异显著（77% vs 16%）。使用多变量分析，我们确定疾病负担作为移植结果的预后因素，3年OS在达到缓解的患者中为80%，而在未缓解的患者中仅为45%。我们的研究结果表明，化疗后异基因造血干细胞移植提供了一个生存优势相比，化疗，和患者在移植前缓解可能会经历一个更好的结果。(C)2016爱思唯尔有限公司版权所有。
The optimal treatment approach for mixed phenotype acute leukemia (MPAL) remains unknown, and prognostic factors for treatment outcomes need to be identified. In this study, 66 patients diagnosed with MPAL according to criteria published by the WHO in 2008 were retrospectively assessed to evaluate the effectiveness of treatment and identify predictive variables. Five patients died of severe infection after the first induction chemotherapy, 29 received alloHSCT after induction (HSCT group), and 32 received only chemotherapy (chemotherapy group). The 3-year OS and DFS estimates for the entire cohort were 45% and 38%, respectively, and the 3-year OS differed significantly between the HSCT and chemotherapy-only groups (77% versus 16%). Using multivariate analyses, we identified disease burden as a prognostic factor for transplantation outcome, with the 3-year OS being 80% among patients who achieved remission and only 45% among patients in cases of nonremission. Our results indicate that alloHSCT after chemotherapy offers a survival advantage compared with chemotherapy only, and patients in remission before transplantation may experience a better outcome. (C) 2016 Elsevier Ltd. All rights reserved.