Reduced-intensity versus conventional myeloablative conditioning allogeneic stem cell transplantation for patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation
Reduced-intensity versus conventional myeloablative conditioning allogeneic stem cell transplantation for patients with acute lymphoblastic leukemia: a retrospective study from the European Group for Blood and Marrow Transplantation
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DOI：
10.1182/blood-2010-02-266551
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发表时间：
2010-11-25
期刊：
影响因子：
20.3
通讯作者：
Rocha, Vanderson
中科院分区：
文献类型：
--
作者：
Mohty, Mohamad;Labopin, Myriam;Rocha, Vanderson
这项回顾性研究评估了576例年龄为bb0 = 45岁的成年急性淋巴细胞白血病患者的预后，这些患者在完全缓解期间接受了来自人类白细胞抗原相同的兄弟姐妹的低强度调节（RIC; n = 127）或清髓调节（MAC; n = 449）同种异体干细胞移植（allogeneic stem cell transplantation, alloc - sct）。中位随访16个月，在2年的时间里，非复发死亡率和复发率的累积发生率分别为29% +/- 2% （MAC）和21% +/- 5% (RIC, P = 0.03), 31% +/- 2% （MAC）和47% +/- 5% （RIC, P < 0.001）。在一项多变量分析中，RIC受体的非复发死亡率降低（P = 0.0001，危险比[HR] = 1.98），而复发率较高（P = 0.03，危险比[HR] = 0.59）。2年时，LFS为38% +/- 3% （MAC）和32% +/- 6% （RIC; P = .07）。在多变量分析中，调理方案类型（RIC vs. MAC）与无白血病生存无显著相关（P = 0.23, HR = 0.84）。尽管需要随机试验，我们的结论是，来自人类白细胞抗原相同的供体的RIC同种异体sct是年龄bb0 = 45岁完全缓解且不适合MAC同种异体sct的急性淋巴细胞白血病患者的潜在治疗选择。(血。2010;116 (22):4439 - 4443)
This retrospective study assessed the outcome of 576 adult acute lymphoblastic leukemia patients aged >= 45 years, and who received a reduced-intensity conditioning (RIC; n = 127) or myeloablative conditioning (MAC; n = 449) allogeneic stem cell transplantation (allo-SCT) from a human leukocyte antigen-identical sibling while in complete remission. With a median follow-up of 16 months, at 2 years, the cumulative incidences of nonrelapse mortality and relapse incidence were 29% +/- 2% (MAC) versus 21% +/- 5% (RIC; P = .03), and 31% +/- 2% (MAC) versus 47% +/- 5% (RIC; P < .001), respectively. In a multivariate analysis, nonrelapse mortality was decreased in RIC recipients (P = .0001, hazard ratio [HR] = 1.98) whereas it was associated with higher relapse rate (P = .03, HR = 0.59). At 2 years, LFS was 38% +/- 3% (MAC) versus 32% +/- 6% (RIC; P = .07). In multivariate analysis, the type of conditioning regimen (RIC vs. MAC) was not significantly associated with leukemia-free survival (P = .23, HR = 0.84). Despite the need for randomized trials, we conclude that RIC allo-SCT from a human leukocyte antigen-identical donor is a potential therapeutic option for acute lymphoblastic leukemia patients aged >= 45 years in complete remission and not eligible for MAC allo-SCT. (Blood. 2010;116(22):4439-4443)