Superior outcome of patients with favorable-risk acute myeloid leukemia using consolidation with autologous stem cell transplantation
Superior outcome of patients with favorable-risk acute myeloid leukemia using consolidation with autologous stem cell transplantation
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DOI：
10.1080/10428194.2019.1594214
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发表时间：
2019-08-24
影响因子：
2.6
通讯作者：
Zuckerman, Tsila
中科院分区：
文献类型：
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作者：
Beyar-Katz, Ofrat;Lavi, Noa;Zuckerman, Tsila
自体造血干细胞移植（ASCT），加强抗白血病的作用，没有显着的治疗相关死亡率（TRM），是特别有吸引力的AML与有利的遗传/分子特征。本研究回顾性评价了缓解后治疗连续可缓解风险AML患者的结局。纳入66例患者：32例NPM 1/野生型FLT-ITD突变，16例t（8：21）和18例？inv（16）. 40例患者接受了单独化疗，26例患者接受了ASCT。在时间依赖性分析中，ASCT组的无复发率（RFS）较高（p =？。001)和总生存率（OS）（p =？。0007）。化疗和ASCT的1年RFS和OS分别为44.2%和88%，71%和96%。相应的TRM分别为4/40（10.0%）和0/26（0%），复发率分别为70.0%和19.2%（p =？。0002）。在多变量分析中，ASCT与上级OS和RFS相关。总之，ASCT为首次完全缓解的高危AML患者提供了显著优越的上级RFS和OS。这些数据支持最近对AML ASCT的兴趣重新抬头。
Autologous stem cell transplantation (ASCT), intensifying anti-leukemic effects without significant treatment-related mortality (TRM), is particularly appealing in AML with favorable genetic/molecular profile. This study retrospectively evaluated the outcomes of post-remission treatment in consecutive favorable-risk AML patients. Sixty-six patients were included: 32 had mutated NPM1/wild-type FLT-ITD, 16 had t(8:21) and 18???inv(16). Forty patients received chemotherapy alone, 26 underwent ASCT upfront. In time-dependent analysis, the ASCT group demonstrated higher relapse-free (RFS) (p?=?.001) and overall survivals (OS) (p?=?.0007). The 1-year RFS and OS were 44.2% vs 88% and 71% vs 96% for chemotherapy and ASCT, respectively. The corresponding TRM was 4/40 (10.0%) and 0/26 (0%), with relapse rates of 70.0% and 19.2% (p?=?.0002). In multivariate analysis, ASCT was associated with superior OS and RFS. In conclusion, ASCT offers significantly superior RFS and OS in favorable-risk AML in first complete remission. These data support the recent resurgence of interest in ASCT for AML.