Outcome of therapy‐related myelodysplastic syndrome and oligoblastic acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation: A propensity score matched analysis
Outcome of therapy‐related myelodysplastic syndrome and oligoblastic acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation: A propensity score matched analysis
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异基因造血干细胞移植后治疗相关骨髓增生异常综合征和少母细胞急性髓系白血病的结果：倾向评分匹配分析
DOI：
10.1002/hon.2991
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发表时间：
2022
影响因子：
3.3
通讯作者：
I
中科院分区：
文献类型：
--
作者：
Itonaga Hidehiro;Kida Michiko;Hamamura Atsushi;Uchida Naoyuki;Ozawa Yukiyasu;Fukuda Takahiro;Ueda Yasunori;Kataoka Keisuke;Katayama Yuta;Ota Shuichi;Matsuoka Ken‐ichi;Kondo Tadakazu;Eto Tetsuya;Kanda Junya;Ichinohe Tatsuo;Atsuta Yoshiko;Miyazaki Yasushi;I
与治疗相关的骨髓增生异常综合征(t-MDS)通常是进展性的，与初治MDS(d-MDS)相比，预后较差。为了评估异基因造血干细胞移植(allo-HSCT)治疗t-MDS的结果，我们利用全国数据库对t-MDS和d-MDS患者进行了倾向分数配对分析。2001年至2018年，共有178名t-MDS患者接受了allo-HSCT，3123名d-MDS患者中有178名入选。T-MDS组和d-MDS组3年总生存率分别为40.0%和50.0%(P=0.032)。T-MDS组和d-MDS组的3年移植相关死亡率分别为30.9%和19.0%(p=0.005)。T-MDS组和d-MDS组的3年累积复发率分别为32.8%和33.0%(p=0.983)。多变量分析确定了四个影响t-≥组总体生存的不利因素：年龄>55岁(风险比，2.09；95%可信区间，1.11-3.94；p=0.023)，较差的细胞遗传学风险组(HR，2.19；95%可信区间，1.4-4.19；p=0.019)，异基因造血干细胞移植2-4期的表现状况(HR，2.14；95%可信区间，1.19-3.86；p=0.011)，从诊断到移植的较短间隔(<；8个月；HR，1.61；95%CI，1.00-2.57；p=0.048)。移植相关死亡最常见的原因是t-MDS组的感染并发症(21.6%)和d-MDS组的器官衰竭(12.5%)。综上所述，allo-HSCT有可能为t-MDS患者提供长期缓解；然而，还需要进一步努力减少移植相关死亡。
Therapy‐related myelodysplastic syndromes (t‐MDS) are generally progressive and associated with poorer outcomes than de novo MDS (d‐MDS). To evaluate the outcome of allogeneic hematopoietic stem cell transplantation (allo‐HSCT) for t‐MDS, we conducted a propensity score matched‐pair analysis of patients with t‐MDS and d‐MDS using a nationwide database. A total of 178 patients with t‐MDS underwent allo‐HSCT between 2001 and 2018, and 178 out of 3123 patients with d‐MDS were selected. The probability of 3‐year overall survival rate was 40.0% and 50.0% in the t‐MDS and d‐MDS groups, respectively (p= 0.032). The 3‐year transplant‐related mortality was 30.9% and 19.0% in the t‐MDS and d‐MDS groups, respectively (p= 0.005). The 3‐year cumulative incidence of relapse was 32.8% and 33.0% in the t‐MDS and d‐MDS groups, respectively (p= 0.983). A multivariate analysis identified four adverse factors for overall survival in the t‐MDS group: age ≥ 55 years (hazard ratio [HR], 2.09; 95% CI, 1.11–3.94;p= 0.023), the poor cytogenetic risk group (HR, 2.19; 95% CI, 1.40–4.19;p= 0.019), performance status at allo‐HSCT 2–4 (HR, 2.14; 95% CI, 1.19–3.86;p= 0.011), and a shorter interval from diagnosis to transplantation (<8 months; HR, 1.61; 95% CI, 1.00–2.57;p= 0.048). The most frequent cause of transplant‐related death was the infectious complications (21.6%) in t‐MDS group and organ failure (12.5%) in d‐MDS group. In conclusion, allo‐HSCT potentially provides long‐term remission in patients with t‐MDS; however, further efforts to reduce transplant‐related death are needed.
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影响因子：
45.3
作者：
McClune, Brian L.;Weisdorf, Daniel J.;Giralt, Sergio
通讯作者：
Giralt, Sergio
影响因子：
20.3
作者：
Holtan, Shernan G.;DeFor, Todd E.;Weisdorf, Daniel J.
通讯作者：
Weisdorf, Daniel J.
影响因子：
4.8
作者：
Pohlen, M.;Groth, C.;Stelljes, M.
通讯作者：
Stelljes, M.
影响因子：
45.3
作者：
Bejar, Rafael;Stevenson, Kristen E.;Ebert, Benjamin L.
通讯作者：
Ebert, Benjamin L.
影响因子：
2.7
作者：
Falantes, Jose F.;Calderon, Cristina;Perez-Simon, Jose A.
通讯作者：
Perez-Simon, Jose A.