Outcomes of Second Allogeneic Hematopoietic Cell Transplantation for Patients With Acute Myeloid Leukemia.
Outcomes of Second Allogeneic Hematopoietic Cell Transplantation for Patients With Acute Myeloid Leukemia.
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DOI：
10.1016/j.jtct.2021.05.007
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发表时间：
2021-08
影响因子：
3.2
通讯作者：
Kebriaei P
中科院分区：
文献类型：
--
作者：
Yalniz FF;Saliba RM;Greenbaum U;Ramdial J;Popat U;Oran B;Alousi A;Olson A;Alatrash G;Marin D;Rezvani K;Hosing C;Im J;Mehta R;Qazilbash M;Joseph JJ;Rondon G;Kanagal-Shamanna R;Shpall E;Champlin R;Kebriaei P
同种异体造血细胞移植（HCT）后复发导致急性髓系白血病（AML）患者生存率低。第二次HCT （HCT2）可获得持久缓解。确定接受HCT2治疗复发性AML患者的预后，并评估总生存期（OS）和无进展生存期（PFS）的预测因素。我们回顾性地回顾了2000-2019年在我们机构接受HCT2治疗复发性AML的成年患者的医疗记录。91例患者在HCT2时的中位年龄为44岁（范围18-73岁）。供体类型为hla -同卵兄弟（n=37, 41%）、hla -不相关（n=34, 37%）、单倍同卵（n=19, 21%）和脐带血（n= 1.1, 1%）。在53%的患者中，供者的HCT2不同。大多数患者接受了降低强度调节（n= 71,78%），并在HCT2时缓解（n= 56,61%）。HCT1后的中位缓解持续时间为8.4个月（范围1-70），移植之间的中位时间为14个月（范围3-73）。HCT2后存活患者的中位随访时间为66个月（范围2-171），分析时32%的患者存活。最常见的死亡原因是疾病复发（n=45, 73%）。2年时，OS、PFS、进展和非复发死亡率分别为36%、27%、42%和18%。首次HCT后慢性GVHD的发展和HCT合并症指数(HCT- ci)≥2与HCT2后较差的PFS和OS相关。在HCT1后复发的AML患者中，第二次HCT是可行的。在HCT1和HCT2时HCT-CI <2后无慢性GVHD患者的长期生存获益是可能的。
Relapse after allogeneic hematopoietic cell transplantation (HCT) leads to poor survival in patients with acute myeloid leukemia (AML). A second HCT (HCT2) may achieve durable remission. To determine the outcomes of patients who received an HCT2 for relapsed AML and to evaluate the predictors of overall survival (OS) and progression-free survival (PFS). We retrospectively reviewed medical records of adult patients who underwent an HCT2 for relapsed AML at our institution during 2000–2019. Ninety-one patients were identified with a median age of 44 years (range, 18–73) at HCT2. Donor types were HLA-identical sibling (n=37, 41%), HLA-matched-unrelated (n=34, 37%), haploidentical (n=19, 21%), and cord-blood (n=1, 1%). Donors were different at HCT2 in 53% of patients. The majority of patients received reduced intensity conditioning (n=71, 78%) and were in remission (n=56, 61%) at HCT2. The median remission duration after HCT1 was 8.4 months (range, 1–70) and the median time between transplants was 14 months (range, 3–73). The median follow-up of surviving patients after HCT2 was 66 months (range, 2–171), with 32% alive at time of analysis. The most common cause of death was disease recurrence (n=45, 73%). At 2 years, the rates of OS, PFS, progression, and non-relapse mortality were 36%, 27%, 42%, and 18%, respectively. The development of chronic GVHD after first HCT and HCT comorbidity index (HCT-CI) ≥2 at HCT2 were associated with inferior PFS and OS after HCT2. A second HCT is feasible in selected patients with AML who have relapsed after HCT1. Long-term survival benefit is possible in patients without chronic GVHD after HCT1 and HCT-CI <2 at HCT2.
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影响因子：
20.3
作者：
SULLIVAN, KM;SHULMAN, HM;THOMAS, ED
通讯作者：
THOMAS, ED
影响因子：
4.8
作者：
Hosing, C;Saliba, RM;De Lima, M
通讯作者：
De Lima, M
影响因子：
4.3
作者：
Yaniv, Isaac;Krauss, Aviva C.;Bader, Peter
通讯作者：
Bader, Peter
影响因子：
11.1
作者：
Canaani, J.;Beohou, E.;Nagler, A.
通讯作者：
Nagler, A.
DOI：
10.1016/j.bbmt.2018.06.016
发表时间：
2018-10
期刊：
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
影响因子：
--
作者：
de Lima M;Oran B;Champlin RE;Papadopoulos EB;Giralt SA;Scott BL;William BM;Hetzer J;Laille E;Hubbell B;Skikne BS;Craddock C
通讯作者：
Craddock C