Feasibility of treating post-transplantation minimal residual disease in children with acute leukemia.
Feasibility of treating post-transplantation minimal residual disease in children with acute leukemia.
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DOI：
10.1016/j.bbmt.2014.03.021
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发表时间：
2014-07
影响因子：
4.3
通讯作者：
Chen, Allen R.
中科院分区：
文献类型：
--
作者：
Shah, Nirali N.;Borowitz, Michael J.;Robey, Nancy C.;Gamper, Christopher J.;Symons, Heather J.;Loeb, David M.;Wayne, Alan S.;Chen, Allen R.
异基因造血干细胞移植（HCT）后明显复发的恶性血液病患者的结局较差。关于移植后微小残留病（MRD）结局的数据有限。在这个单一的机构中，我们对急性白血病和骨髓增生异常综合征儿童进行了回顾性队列分析，记录了复发的模式，主要关注移植后MRD的结局。接受首次同种异体HCT的93例患者中有40例（43%）在移植后+30、+60、+90、+180天和+1和+2年时进行了系统的移植前和移植后MRD评价，出现复发。复发的中位时间为移植后4.8个月，复发后中位生存期为4个月。尽管进行了频繁的、系统的、常规的HCT后疾病再分期评估，但31例患者（78%）在复发时表现出明显的疾病。7例急性白血病患者发生移植后MRD，中位时间为移植后1个月。由于快速疾病进展或治疗相关死亡率（TRM），在移植后MRD状态下检测到白血病的患者的生存率没有改善。我们的研究结果表明，针对急性白血病移植后MRD复发预防的早期干预策略可能不可行。
Outcomes for patients with hematologic malignancies who experience overt relapse after allogeneic hematopoietic stem cell transplantation (HCT) are poor. There are limited data on outcomes of post-transplant minimal residual disease (MRD). In this single institution, retrospective cohort analysis of children with acute leukemia and myelodysplastic syndrome we document the pattern of relapse with a primary focus on outcomes of post-transplant MRD. Forty of 93 (43%) patients who underwent a first allogeneic HCT and who all had systematic pre and post-transplant MRD evaluations at +30, +60, +90, +180 days and at +1 and +2 years post-transplant, experienced relapse. The median time to relapse was 4.8 months post-transplant with a median survival of 4 months post-relapse. Despite frequent, systematic, routine post-HCT disease restaging evaluation, 31 patients (78%) presented with overt disease at the time of relapse. 7 patients with acute leukemia who had post-transplant MRD, presented at a median of 1 month post-transplant. Due to rapid disease progression or treatment-related mortality (TRM), there was no improvement in survival for those patients whose leukemia was detected in a state of MRD post-transplant. Our results suggest that early intervention strategies targeting post-transplant MRD for relapse prevention in acute leukemia may not be feasible.
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影响因子：
6.5
作者：
Bader, P;Niemeyer, C;Beck, JF
通讯作者：
Beck, JF
影响因子：
45.3
作者：
Bader, P;Kreyenberg, H;Klingebiel, T
通讯作者：
Klingebiel, T
影响因子：
4.3
作者：
Alyea, Edwin P.;DeAngelo, Daniel J.;Moldrem, Jeffrey;Pagel, John M.;Przepiorka, Donna;Sadelin, Michel;Young, James W.;Giralt, Sergio;Bishop, Michael;Riddell, Stan
通讯作者：
Riddell, Stan
DOI：
10.1016/j.bbmt.2010.06.008
发表时间：
2010-09
期刊：
Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
影响因子：
--
作者：
Kröger N;Bacher U;Bader P;Böttcher S;Borowitz MJ;Dreger P;Khouri I;Macapinlac HA;Olavarria E;Radich J;Stock W;Vose JM;Weisdorf D;Willasch A;Giralt S;Bishop MR;Wayne AS
通讯作者：
Wayne AS
影响因子：
4.3
作者：
de Lima, Marcos;Porter, David L.;Battiwalla, Minoo;Bishop, Michael R.;Giralt, Sergio A.;Hardy, Nancy M.;Kroeger, Nicolaus;Wayne, Alan S.;Schmid, Christoph
通讯作者：
Schmid, Christoph