Donor lymphocyte infusions for the treatment of chronic myeloid leukemia relapse following peripheral blood or bone marrow stem cell transplantation.
Donor lymphocyte infusions for the treatment of chronic myeloid leukemia relapse following peripheral blood or bone marrow stem cell transplantation.
复制标题
供体淋巴细胞输注用于治疗外周血或骨髓干细胞移植后慢性粒细胞白血病复发。
DOI：
10.1038/bmt.2012.234
复制
发表时间：
2013
影响因子：
4.8
通讯作者：
Basak GW
中科院分区：
文献类型：
--
作者：
Basak GW
众所周知，与骨髓移植 (BMT) 相比，用作移植干细胞来源的外周血 (PBSCT) 具有更强的免疫介导作用。我们决定回顾性分析干细胞来源对 CML 患者 OS 的影响，这些患者在匹配相关供者 PBSCT (N= 168) 或 BMT (N= 216) 后复发并接受供者淋巴细胞输注 (DLI) 治疗。单变量分析显示，与 BMT 相比，PBSCT 后复发的患者在 DLI 后的 OS 概率较低（5 年时分别为 66% 和 79%，P=0.013）。然而，多变量 Cox 分析并未显示 PBSCT 作为第一慢性期移植患者 OS 降低的危险因素有任何显着影响（CP1；风险比 (HR) 1.036，95% 置信区间 (CI) 0.619–1.734）。统计交互项表明，干细胞来源对 DLI 后 OS 的影响对于晚期移植的患者是不同的（先前 PBSCT 的负面影响 — HR 2.176，95% CI 0.930–5.091）。综上所述，干细胞来源不会影响 CP1 期接受 PBSCT、复发并接受 DLI 治疗的 CML 患者的 OS。然而，当患者在晚期进行移植时，与 BMT 相比，先前的 PBSCT 似乎会对 DLI 后的 OS 产生负面影响。
Peripheral blood used as a source of stem cells for transplantation (PBSCT) is known to exert stronger immune-mediated effects compared with BM (BMT). We decided to retrospectively analyze the impact of stem cell source on the OS of CML patients who relapsed after either matched related donor PBSCT (N= 168) or BMT (N= 216) and were treated with donor lymphocyte infusions (DLI). Univariate analysis revealed a lower probability of OS after DLI in patients relapsing after PBSCT vs BMT (66% vs 79% at 5 years, P= 0.013). However, a multivariate Cox analysis did not reveal any significant impact of PBSCT as a risk factor for decreased OS for patients transplanted in first chronic phase (CP1; hazard ratio (HR) 1.036, 95% confidence interval (CI) 0.619–1.734). A statistical interaction term suggested that the impact of stem cell source on OS after DLI was different for those transplanted in advanced phases (negative impact of previous PBSCT—HR 2.176, 95% CI 0.930–5.091). In summary, the stem cell source does not affect the OS of CML patients who underwent PBSCT in CP1, relapsed and were treated with DLI. However, when the patients were transplanted in advanced phases, previous PBSCT seems to negatively affect OS after DLI compared with BMT.