Predictors of hematologic malignancy relapse in patients with advanced chronic graft-versus-host disease.
Predictors of hematologic malignancy relapse in patients with advanced chronic graft-versus-host disease.
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DOI：
10.1038/s41409-021-01211-2
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发表时间：
2021-07
影响因子：
4.8
通讯作者：
Pavletic SZ
中科院分区：
文献类型：
--
作者：
Ruben CL;Pirsl F;Steinberg SM;Holtzman NG;Parsons-Wandell L;Baruffaldi J;Curtis LM;Mitchell SA;Kerep AZ;Cowen EW;Berger A;Joe GO;Datiles MB 3rd;Mays JW;Pavletic SZ
异基因造血干细胞移植（allo-HSCT）后，骨髓瘤复发仍然是患者治疗成功的主要障碍。慢性移植物抗宿主病（cGVHD）显著降低血液恶性肿瘤复发风险，但这些患者仍会复发。患有中度或重度cGVHD的患者（n=275）入组美国国家癌症研究所（NCI）前瞻性横断面自然史研究（NCT 00092235）。受试者在allo-HSCT后中位数为36个月，随后随访恶性肿瘤复发和生存。17例患者复发。在包括复发时间依赖性影响的多变量模型中，与复发风险增加相关的风险因素包括从移植到cGVHD评估的时间较短（HR 0.279，95% CI 0.078-0.995）和cGVHD全身免疫抑制治疗的既往线数较低（HR 0.260，95% CI 0.094-0.719）。在排除复发风险的时间依赖性影响的模型中，cGVHD的既往全身免疫抑制治疗线数较低（HR 0.288，95% CI 0.103-0.804），C4补体水平较低（HR 0.346，95% CI 0.129-0.923）和较高的体重指数（HR 3.222，95% CI 1.156-8.974）均与复发风险增加相关。表明cGVHD严重程度和活性的参数与恶性肿瘤复发的风险相关。allo-HSCT后复发的经典预测因子似乎不具有预后意义。
Malignancy relapse remains a major barrier to treatment success in patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Chronic graft-versus-host disease (cGVHD) markedly reduces hematologic malignancy relapse risk, but relapses still occur in these patients. Patients (n=275) with moderate or severe cGVHD were enrolled on the National Cancer Institute (NCI) prospective cross-sectional natural history study (NCT00092235). Subjects were median 36 months after allo-HSCT and were followed subsequently for malignancy relapse and survival. Seventeen patients experienced relapse. In a multivariable model including time-dependent influences on relapse, risk factors associated with increased risk of relapse included shorter time from transplant to cGVHD evaluation (HR 0.279, 95% CI 0.078-0.995) and lower number of prior lines of systemic immunosuppressive therapy for cGVHD (HR 0.260, 95% CI 0.094-0.719). In a model excluding time-dependent influences on relapse risk, lower number of prior lines of systemic immunosuppressive therapy for cGVHD (HR 0.288, 95% CI 0.103-0.804), lower C4 complement level (HR 0.346, 95% CI 0.129-0.923), and higher body mass index (HR 3.222, 95% CI 1.156-8.974), were all associated with increased relapse risk. Parameters indicating cGVHD severity and activity are associated with risk of malignancy relapse. Classical predictors of relapse after allo-HSCT do not seem to be prognostic.
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影响因子：
168.9
作者：
Renehan, Andrew G.;Tyson, Margaret;Zwahlen, Marcel
通讯作者：
Zwahlen, Marcel
影响因子：
20.3
作者：
Armand, Philippe;Kim, Haesook T.;Saber, Wael
通讯作者：
Saber, Wael
影响因子：
6.5
作者：
PREISLER, HD;ANDERSON, K;HOLLAND, JF
通讯作者：
HOLLAND, JF
影响因子：
4.5
作者：
Miflin, G;Russell, NH;Bell, A
通讯作者：
Bell, A
缓解急性淋巴细胞白血病儿童无关绳索血液移植后长期复发风险相关的因素。
DOI：
10.1016/j.bbmt.2017.04.015
发表时间：
2017-08
期刊：
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
影响因子：
--
作者：
Page KM;Labopin M;Ruggeri A;Michel G;Diaz de Heredia C;O'Brien T;Picardi A;Ayas M;Bittencourt H;Vora AJ;Troy J;Bonfim C;Volt F;Gluckman E;Bader P;Kurtzberg J;Rocha V
通讯作者：
Rocha V