Prevention of relapse using granulocyte CSF-primed PBPCs following HLA-mismatched/haploidentical, T-cell-replete hematopoietic SCT in patients with advanced-stage acute leukemia: a retrospective risk-factor analysis
Prevention of relapse using granulocyte CSF-primed PBPCs following HLA-mismatched/haploidentical, T-cell-replete hematopoietic SCT in patients with advanced-stage acute leukemia: a retrospective risk-factor analysis
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晚期急性白血病患者在 HLA 不匹配/半相合、T 细胞充足的造血 SCT 后使用粒细胞 CSF 引发的 PBPC 预防复发：回顾性危险因素分析
DOI：
10.1038/bmt.2011.213
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发表时间：
2012-08-01
影响因子：
4.8
通讯作者：
Huang, X-J
中科院分区：
文献类型：
--
作者：
Wang, Y.;Liu, D-H;Huang, X-J
供体淋巴细胞输注（DLI）在预防复发中的作用尚未确定。我们回顾性分析了88例HLA错配/半相合造血干细胞移植（HSCT）后的晚期急性白血病患者的数据，这些患者的治疗包括（n= 61）或不包括（n= 27）粒细胞CSF（GCSF）预充的PBPC输注（GPBPCI）。比较两组患者的复发率和OS，并对危险因素进行详细分析。接受预防性GPBPCI和未接受预防性GPBPCI的患者的2年累积复发率分别为36%和55%（P= 0.017）。接受预防性GPBPCI的患者3年估计生存率为31%，未接受预防性GPBPCI的患者为11%（P= 0.001）。接受预防性GPBPCI的患者的3年无白血病生存率（22%）也高于未接受预防性GPBPCI的患者（11%）（P= 0.003）。复发的多因素分析显示，移植后预防性GPBPCI的使用是一个独立的预后因素（P= 0.025）。较高的OS与使用预防性GPBPCI（P= 0.002）、AML（P= 0.027）和女性（P= 0.023）相关。我们的研究结果表明，使用预防性GPBPCI可能会增加接受HLA不匹配/半相合HSCT的晚期急性白血病患者的生存率。
The role of donor lymphocyte infusion (DLI) in the prophylaxis of relapse has not been defined. We retrospectively analyzed the data from 88 patients with advanced-stage acute leukemia after HLA-mismatched/haploidentical hematopoietic SCT (HSCT) whose treatment did (n= 61) or did not (n= 27) include granulocyte CSF (GCSF)-primed PBPCs infusion (GPBPCI). The two groups were compared with respect to relapse and OS. Further, a detailed analysis of risk factors was performed. The 2-year cumulative incidence of relapse in patients receiving prophylactic GPBPCI and not receiving prophylactic GPBPCI were 36% and 55%(P= 0.017), respectively. Estimated survival at 3 years was 31% for patients receiving prophylactic GPBPCI and 11% for patients not receiving prophylactic GPBPCI (P= 0.001). The three-year probability of leukemia-free survival was also higher in patients who received prophylactic GPBPCI (22%) compared with patients who did not (11%)(P= 0.003). Multivariate analysis for relapse showed that use of prophylactic GPBPCI after transplantation was an independent prognostic factor (P= 0.025). Higher OS was associated with use of prophylactic GPBPCI (P= 0.002), AML (P= 0.027) and female sex (P= 0.023). Our results suggest that use of prophylactic GPBPCI may increase survival of patients with advanced-stage acute leukemia who receive HLA-mismatched/haploidentical HSCT.