Optimal timing of allogeneic hematopoietic stem cell transplantation in patients with myelodysplastic syndrome.
Optimal timing of allogeneic hematopoietic stem cell transplantation in patients with myelodysplastic syndrome.
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DOI：
10.1002/ajh.23458
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发表时间：
2013-07
影响因子：
12.8
通讯作者：
Raimondi, R.
中科院分区：
文献类型：
--
作者：
Alessandrino, Emilio Paolo;Della Porta, Matteo G.;Malcovati, Luca;Jackson, Christopher H.;Pascutto, Cristiana;Bacigalupo, Andrea;van Lint, Maria Teresa;Falda, Michele;Bernardi, Massimo;Onida, Francesco;Guidi, Stefano;Iori, Anna Paola;Cerretti, Raffaella;Marenco, Paola;Pioltelli, Pietro;Angelucci, Emanuele;Oneto, Rosi;Ripamonti, Francesco;Rambaldi, Alessandro;Bosi, Alberto;Cazzola, Mario;Levis, A.;Rambaldi, A.;Bandini, G.;Casini, M.;Rossi, G.;Angelucci, E.;Baronciani, D.;La Nasa, G.;Milone, G.;Mordini, N.;Guidi, S.;Bosi, A.;Bacigalupo, A.;Van Lint, M. T.;Corradini, P.;Milani, R.;Morra, E.;Marenco, P.;Deliliers, G. Lambertenghi;Onida, F.;Ciceri, F.;Bernardi, M.;Castagna, L.;Narni, F.;Pioltelli, P.;Selleri, Carmine;Scime, R.;Iannitto, E.;Musso, M.;Alessandrino, E. P.;Locatelli, F.;Zecca, M.;Martelli, F.;Visani, G.;Di Bartolomeo, P.;Cavanna, L.;Papineschi, F.;Messina, G.;Merli, F.;Iori, A. P.;Foa, R.;Locasciulli, A.;Majolino, I.;Chiusolo, P.;Leone, G.;Arcese, W.;Cerretti, R.;Carella, A. M.;Cascavilla, N.;Mazza, P.;Falda, M.;Bruno, B.;Boccadoro, M.;Fanin, R.;Cerno, M.;Raimondi, R.
同种异体造血干细胞移植（HSCT）是骨髓增生异常综合征（MDS）患者唯一的治疗方法，但其发病率和死亡率不容忽视。登记研究表明，移植时疾病晚期与较低的总生存率相关。为了确定同种异体造血干细胞移植的最佳时机，我们对660名接受最佳支持治疗的患者和449名接受移植的患者进行了决策分析。风险评估基于国际预后评分系统（IPSS）和世界卫生组织基于分类的预后评分系统（WPSS）。我们使用连续时间多状态马尔可夫模型来描述疾病的自然历史，并评估同种异体造血干细胞移植对生存的影响。该模型根据不同风险阶段的治疗政策从诊断估计预期寿命。相对于支持治疗，当移植从初始阶段延迟到进展到中等-1 ipss风险阶段或中等wpss风险阶段时，估计的预期寿命增加，然后在高风险阶段降低。对WPSS和IPSS的建模决策分析可以更好地估计移植的最佳时机。这些观察结果表明，在MDS患者进展到疾病晚期之前进行同种异体造血干细胞移植可提供最佳的生存益处。点。中华血液学杂志，2013,31(2):581 - 588。©2013 Wiley期刊公司
Allogeneic hematopoietic stem cell transplantation (HSCT) represents the only curative treatment for patients with myelodysplastic syndrome (MDS), but involves non-negligible morbidity and mortality. Registry studies have shown that advanced disease stage at transplantation is associated with inferior overall survival. To define the optimal timing of allogeneic HSCT, we carried out a decision analysis by studying 660 patients who received best supportive care and 449 subjects who underwent transplantation. Risk assessment was based on both the International Prognostic Scoring System (IPSS) and the World Health Organization classification-based Prognostic Scoring System (WPSS). We used a continuous-time multistate Markov model to describe the natural history of disease and evaluate the effect of allogeneic HSCT on survival. This model estimated life expectancy from diagnosis according to treatment policy at different risk stages. Relative to supportive care, estimated life expectancy increased when transplantation was delayed from the initial stages until progression to intermediate-1 IPSS-risk or to intermediate WPSS-risk stage, and then decreased for higher risks. Modeling decision analysis on WPSS versus IPSS allowed better estimation of the optimal timing of transplantation. These observations indicate that allogeneic HSCT offers optimal survival benefits when the procedure is performed before MDS patients progress to advanced disease stages. Am. J. Hematol. 88:581–588, 2013. © 2013 Wiley Periodicals, Inc.
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影响因子：
6.2
作者：
Sung, L;Buckstein, R;Detsky, AS
通讯作者：
Detsky, AS
影响因子：
20.3
作者：
Greenberg, P;Cox, C;Bennett, J
通讯作者：
Bennett, J
影响因子：
1.9
作者：
KALBFLEISCH, JD;LAWLESS, JF;VOLLMER, WM
通讯作者：
VOLLMER, WM
DOI：
10.1056/nejmoa1013343
发表时间：
2011-06-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Bejar R;Stevenson K;Abdel-Wahab O;Galili N;Nilsson B;Garcia-Manero G;Kantarjian H;Raza A;Levine RL;Neuberg D;Ebert BL
通讯作者：
Ebert BL
DOI：
10.1056/nejmoa1103283
发表时间：
2011-10-13
期刊：
The New England journal of medicine
影响因子：
--
作者：
Papaemmanuil E;Cazzola M;Boultwood J;Malcovati L;Vyas P;Bowen D;Pellagatti A;Wainscoat JS;Hellstrom-Lindberg E;Gambacorti-Passerini C;Godfrey AL;Rapado I;Cvejic A;Rance R;McGee C;Ellis P;Mudie LJ;Stephens PJ;McLaren S;Massie CE;Tarpey PS;Varela I;Nik-Zainal S;Davies HR;Shlien A;Jones D;Raine K;Hinton J;Butler AP;Teague JW;Baxter EJ;Score J;Galli A;Della Porta MG;Travaglino E;Groves M;Tauro S;Munshi NC;Anderson KC;El-Naggar A;Fischer A;Mustonen V;Warren AJ;Cross NC;Green AR;Futreal PA;Stratton MR;Campbell PJ;Chronic Myeloid Disorders Working Group of the International Cancer Genome Consortium
通讯作者：
Chronic Myeloid Disorders Working Group of the International Cancer Genome Consortium