Allogeneic stem cell transplantation for chronic myelomonocytic leukemia: a report from the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire
Allogeneic stem cell transplantation for chronic myelomonocytic leukemia: a report from the Societe Francaise de Greffe de Moelle et de Therapie Cellulaire
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DOI：
10.1111/ejh.12073
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发表时间：
2013-05-01
影响因子：
3.1
通讯作者：
Mohty, Mohamad
中科院分区：
文献类型：
--
作者：
Park, Sophie;Labopin, Myriam;Mohty, Mohamad
目的和方法慢性髓细胞白血病（CMML）是一种严重的疾病，同种异体干细胞移植（allo-SCT）仍然是唯一可能治愈的治疗方法。我们描述了一项回顾性研究，确定了1992年至2009年间在SFGM-TC登记处报告的连续73例CMML患者的同种异体细胞移植后预后因素。结果确诊时中位年龄53岁，36%患者有可触及脾肿大（SPM）。根据IPSS， 48例、13例和9例患者分别为良好、中等和低风险核型，61%的患者为CMML-1, 39%的患者为CMML-2。41/31/1例患者分别有hla相同的兄弟姐妹、无亲缘关系和单倍相同的供体。43例患者接受低强度训练。中位随访时间为23个月，分别有21例和25例患者出现急性24级和慢性GVHD。3年OS、NRM（非复发死亡率）、EFS和CIR（累积复发发生率）分别为32%、36%、29%和35%。OS不受CR状态、异细胞移植时骨髓原细胞百分比、既往治疗和cGVHD的影响。采用多变量分析，移植年份
Objectives and methods Chronic myelomonocytic leukemia (CMML) is a severe disease for which allogeneic stem cell transplantation (allo-SCT) remains the only potentially curative treatment. We describe a retrospective study determining prognostic factors for outcome after allo-SCT in consecutive 73 patients with CMML reported to the SFGM-TC registry between 1992 and 2009. Results At diagnosis, median age was 53yrs, and 36% patients had palpable splenomegaly (SPM). 48, 13, and 9 patients had good, intermediate, and poor risk karyotype, respectively, according to IPSS, 61% patients had CMML-1, and 39% had CMML-2. 41/31/1 cases had an HLA-identical sibling, an unrelated and haploidentical donor, respectively. 43 patients received reduced-intensity conditioning. With a median follow-up of 23month, acute grade 24 and chronic GVHD developed in 21 and 25 patients, respectively. The 3-year OS, NRM (non-relapse mortality),EFS, and CIR (cumulative incidence of relapse) were 32%, 36%, 29% and 35%, respectively. OS was not influenced by the CR status, marrow blasts% at allo-SCT, prior treatments, and cGVHD. Using multivariate analysis, year of transplant