Pretransplant NPM1 MRD levels predict outcome after allogeneic hematopoietic stem cell transplantation in patients with acute myeloid leukemia.
Pretransplant NPM1 MRD levels predict outcome after allogeneic hematopoietic stem cell transplantation in patients with acute myeloid leukemia.
复制标题
放回前NPM1 MRD水平预测急性髓样白血病患者同种异体造血干细胞移植后的结果。
DOI：
10.1038/bcj.2016.46
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发表时间：
2016-07-29
影响因子：
12.8
通讯作者：
Krämer A
中科院分区：
文献类型：
--
作者：
Kayser S;Benner A;Thiede C;Martens U;Huber J;Stadtherr P;Janssen JW;Röllig C;Uppenkamp MJ;Bochtler T;Hegenbart U;Ehninger G;Ho AD;Dreger P;Krämer A
本研究旨在评估67例接受异基因造血干细胞移植（HSCT）的成人NPM 1突变型急性髓系白血病患者移植前微小残留病（MRD）对预后的影响。67例患者中有28例（42%）患有FLT 3-ITD。移植时的中位年龄为54.7岁，从同种异体移植开始的中位随访生存期为4.9年。移植时，31例患者处于第一阶段，20例处于第二阶段完全缓解（CR），16例患有难治性疾病（RD）。在39例CR患者中测量了移植前NPM 1 MRD水平。无论患者是在第一次还是第二次CR时接受移植，CR时移植患者的总生存期（OS）均显著长于RD患者（P=0.004）（P=0.74）。在移植前MRD阳性和MRD阴性患者之间，同种异体HSCT后的OS存在非常显著的差异（估计5年OS率为40 vs 89% P=0.007）。对复发时间和OS的多变量分析显示，移植前NPM 1 MRD水平>1%是异基因HSCT后生存不良的独立预后因素，而FLT 3-ITD没有影响。值得注意的是，移植前NPM 1 MRD阳性>1%的患者的结果与移植RD的患者一样差。
The objective was to evaluate the prognostic impact of pre-transplant minimal residual disease (MRD) as determined by real-time quantitative polymerase chain reaction in 67 adult NPM1-mutated acute myeloid leukemia patients receiving allogeneic hematopoietic stem cell transplantation (HSCT). Twenty-eight of the 67 patients had a FLT3-ITD (42%). Median age at transplantation was 54.7 years, median follow-up for survival from time of allografting was 4.9 years. At transplantation, 31 patients were in first, 20 in second complete remission (CR) and 16 had refractory disease (RD). Pre-transplant NPM1 MRD levels were measured in 39 CR patients. Overall survival (OS) for patients transplanted in CR was significantly longer as compared to patients with RD (P=0.004), irrespective of whether the patients were transplanted in first or second CR (P=0.74). There was a highly significant difference in OS after allogeneic HSCT between pre-transplant MRD-positive and MRD-negative patients (estimated 5-year OS rates of 40 vs 89% P=0.007). Multivariable analyses on time to relapse and OS revealed pre-transplant NPM1 MRD levels >1% as an independent prognostic factor for poor survival after allogeneic HSCT, whereas FLT3-ITD had no impact. Notably, outcome of patients with pre-transplant NPM1 MRD positivity >1% was as poor as that of patients transplanted with RD.
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影响因子：
158.5
作者：
Falini, B;Mecucci, C;Martelli, MF
通讯作者：
Martelli, MF
影响因子：
10.1
作者：
Hubmann, Max;Koehnke, Thomas;Spiekermann, Karsten
通讯作者：
Spiekermann, Karsten
影响因子：
51.1
作者：
Bornhaeuser, Martin;Kienast, Joachim;Stelljes, Matthias
通讯作者：
Stelljes, Matthias
影响因子：
45.3
作者：
Hofmann, Susanne;Goetz, Marlies;Greiner, Jochen
通讯作者：
Greiner, Jochen
影响因子：
6.5
作者：
Cahn, JY;Labopin, M;Gorin, NC
通讯作者：
Gorin, NC