Prognostic impact of complex karyotype on post-transplant outcomes of myelofibrosis.
Prognostic impact of complex karyotype on post-transplant outcomes of myelofibrosis.
复制标题
复杂核型对骨髓纤维化移植后结果的预后影响。
DOI：
10.1002/hon.3058
复制
发表时间：
2022
期刊：
影响因子：
3.3
通讯作者：
Nagamura-Inoue T.
中科院分区：
文献类型：
--
作者：
Okada Y;Takenaka K;Murata M;Shimazu Y;Tachibana T;Ozawa Y;Uchida N;Wakayama T;Doki N;Sugio Y;Tanaka M;Masuko M;Kobayashi H;Ino K;Ishikawa J;Nakamae H;Matsuoka KI;Kanda Y;Fukuda T;Atsuta Y;Nagamura-Inoue T.
染色体异常在骨髓纤维化（MF）移植患者预后因素中的作用尚未得到充分研究。关于复杂核型（CK），我们回顾性分析了241例首次接受同种异体造血细胞移植（HCT）的原发性和继发性MF患者。基于动态国际预后评分系统中的不利核型，我们比较了3组的结果：有利核型、包括CK的不利核型（不利‐CK(+)）和不包括CK的不利核型（不利‐CK(-)）。不利‐CK（+）组的总生存期明显缩短（风险比（HR） 2.49, 95% CI: 1.46-4.24，P< 0.001），而不利‐CK（-）组和有利组之间无差异（风险比0.57,95% CI: 0.20-1.59，P= 0.28）。此外，在不利的‐CK（+）组中，HCT后未达到完全缓解的患者比例明显更高（P= 0.007）。不利‐CK（+）组的累积疾病进展发生率显著高于对照组（HR 2.5, 95% CI 1.6-3.92，P< 0.001），而不利‐CK（-）组的累积疾病进展发生率与有利组相当（HR 0.49, 95% CI 0.12-1.94，P= 0.31）。需要进一步的研究来阐明CK对MF移植结果的影响。
Chromosomal abnormalities in the role of prognostic factor for transplant patients with myelofibrosis (MF) are not fully investigated. Regarding complex karyotype (CK), we retrospectively analyzed 241 patients with primary and secondary MF who received a first allogeneic hematopoietic cell transplantation (HCT). Based on an unfavorable karyotype in the Dynamic International Prognostic Scoring System, we compared the outcomes in 3 groups: favorable karyotype, unfavorable karyotype including CK (unfavorable‐CK(+)), and unfavorable karyotype not including CK (unfavorable‐CK(–)). Overall survival was significantly shorter in the unfavorable‐CK(+) group (hazard ratio (HR) 2.49, 95% CI: 1.46–4.24,P< 0.001), whereas there was no difference between the unfavorable‐CK(–) group and the favorable group (HR 0.57, 95% CI: 0.20–1.59,P= 0.28). In addition, a significantly higher proportion of patients in the unfavorable‐CK(+) group did not achieve complete remission after HCT (P= 0.007). The cumulative incidence of disease progression was significantly higher in the unfavorable‐CK(+) group (HR 2.5, 95% CI 1.6–3.92,P< 0.001), whereas that in the unfavorable‐CK(–) group was comparable to that in the favorable group (HR 0.49, 95% CI 0.12–1.94,P= 0.31). Further investigations will be needed to clarify the impact of CK on transplant outcomes in MF.